The Treatment Of Thoracic And Lumbar Spinal Tuberculosis With Single Posterior Fixation Combined With Laparoscopic Drainage

Objective To evaluate the effect of the treatment of thoracolumbar spinal tuberculosis with single posterior fixation assisted laparoscopic catheter drainage.Methods Thirty-five patients with thoracolumbar spinal tuberculosis,from October 2008 to October 2014, in the Second Affiliated Hospital of Anhui Medical University were analyzed retrospectively. Twenty cases in group A were treated by anterior debridement,bone graft and internal fixation.Fifteen cases in group B were treated by posterior fixation,of which two were assisted laparoscopic catheter drainage.The operation time, blood loss, length of stay, Cobb angle,erythrocyte sedimentation rate(ESR), visual analogue scale(VAS), the Oswestry Disability Index(ODI) and the neurological function recovery were recorded and compared.Results None of these thirty-five cases failed to be followed up,they were followed up for 12-24 months, 18 months on average.There were significant differences in operation time, blood loss and length of stay(P<0.05) between the two groups.Each group,the Cobb angle,ESR,the VAS and ODI score before and after surgery were statistically significant(P<0.05).There were no significant differences in the Cobb angle before operation, ESR,the VAS and ODI score before and after surgery between group A and B(P>0.05).The Cobb angle correction and the loss in the last follow-up between the two groups were statistically significant(P<0.05).According to Frankel classification,group A had preoperative 7 cases in grade D, 13 cases in grade E,postoperative 3 cases in grade D,17 cases in grade E,and group B had preoperative 5 cases in grade D,10 cases in grade E, postoperative 15 cases in grade E.Conclusions 1.Two kinds of surgical approaches can effectively correct the deformity and obtain satisfactory clinical effect. 2.It is also effective for early and medium-term spinal tuberculosis with rational use of anti TB drugs, and no focus debridement.3.Assisted laparoscopic drainage is safe and effective for patients with lumbar major muscle abscess and poor physical condition.