Clinical Study On Surgical Treatment Of Spinal Tuberculosis

Objective To explore the curative effect of the spinal tuberculosis surgical and the advantages and disadvantages of different surgical methods.Methods Select 59 patients meet the inclusion criteria of spinal tuberculosis who treated in the First Affiliated Hospital of Soochow University from January 2006 to December 2015. There were 34 male patients and 25 female patients,the course of disease was 2-60 months,the average of it was 9.3±4.5 months.These patients can be divided into:(group A)18 cases just using anterior debridement including 9 male cases,9 female cases,5 patients had neurological impairment;(group B)19 cases using anterior debridement and posterior pedicle screw fixation,including 11 male cases,8 female cases,14 patients had neurological impairment;(group C)22 cases using posterior debridement and pedicle screw fixation,including 10 male cases,12 female cases,16 patients had neurological impairment.The operation time,operative bleeding volume,hospitalization time,preoperative kyphosis angle,postoperative kyphosis angle and kyphosis angle of 3 months afteroperation,bone fusion,neural function recovery were be compared.Results 59 patients were followed up,the hospitalization time was 12-40 days,follow-up time was 6-48 months.In group A, the average of operation time was176.1±25.5minutes.The average of operative bleeding volume was 975.1±66.8ml.The average of hospitalization time was 28.4±9.5days.The recovery of neurological function was 1 level,and the correction rate of kyphosis angle was 25.2%.In group B,the average of operation time was 280.2±35.6minutes.The average of operative bleeding volume was975.1±66.8ml.The average of Hospitalization time was 28.4±9.5days.The recovery of neurological function was 1.5 level,and the correction rate of kyphosis angle was 72.4%.In group C,the average of operation time was 185.2±27.1minutes.The average of operative bleeding volume was 650.7±42.1m1.The average of hospitalization time was21.6±7.2days,The recovery of neurological function was 1.3 level,and the correction rate of kyphosis angle was 64.0 %.The operation time,operative bleeding volume and hospitalization time of group B are greater than group A and group B. In group A, there is no obvious correction effect to the kyphosis, and in group B and C, there is obvious correction effect to the kyphosis.In 35 patients who with neurological symptoms,postoperative average level of ASIA grade recovery is 1.3.At the last follow-up time,patients who grafted bones all obtained satisfactory effect of bone graft and fusion except one patient.Conclusion For those patients who need surgical treatment of spinal tuberculosis, we should select the appropriate individual operation.Combined with tregular anti tuberculosis drug treatment, the patients can achieve good clinical curative effect.