Clinical Analysis Of Posterior Multifidus Muscle Gap And Transverse Process Approach To Clear Lesion For Lumbar Tuberculosis

Objective: To evaluate of the posterior multifidus muscle gap and intertransverse approach for lumbar tuberculosis clearance, lesions interbody titanium mesh bone particles filled implants support, pedicle screw fixation in the treatment of lumbar tuberculosis clinical curative effect.Methods: From January 2013 to 2015 December, the 21 cases lumbar tuberculosis patients were treated by our department. All of the 21 patients, 13 males and 8 females, the average age of 34.6 years. 12 cases were treated with multifidus muscle gap and intertransverse approach for lumbar tuberculosis debridement, intervertebrae titanium mesh implant support, pedicle screw internal fixation. 9 cases were treated with traditional posterior median approach, lumbar tuberculosis debridement, intervertebrae titanium mesh implant support, pedicle screw internal fixation. Compared between the operation approaches of the operation time, intraoperative blood loss, the height recovery of the section, the degree of the lumbar spinal Cobb angle correction and the incidence rate of postoperative chronic low back pain. Two groups of patients were followed up at the same time. All cases of the average follow-up time was 12 months. The 21 cases of patients with pathological changes in the lumbar spine. The 7 cases of patients who were affected in single vertebral, 9 cases the focus at double vertebral tuberculosis, 5 cases the focus at three vertebral tuberculosis. 4 patients with lumbar spinal cord injury in all cases.Results: Follow-up period, the imaging examination showed that the lumbar spine interal fixation were stable of the two groups of patients. No internal fixation bending, broken nails, short rods and titanium mesh shift, the bone graft were hardly absorbed. The vertebral height and lumbar vertebral Cobb angle had different degrees of recovery before operation. All the patients were cured. In addition to posterior median approach in the treatment of 9 patients, 4 patients with varying degrees of low back pain, but the walking function is not limited, the other patients showed no significant abnormality. There were no recurrence and infection of incision in the two groups.Conclusion: Treatment of lumbar tuberculosis with posterior median approach compared with the multifidus muscle gap and intertransverse approach. The operation time of the multifidus muscle gap approach group was shorter than that of the group, less bleeding in operation, postoperative patients with low incidence of chronic low back pain. Two kinds of surgical methods can effectively remove lumbar tuberculosis lesions, different level restore of the section, effective correction of lumbar spinal convex deformity, lumbar stability recovery sequence and biomechanical stability effectively.