To Evaluate The Clinical Efficacy Of Single Posterior Intervertebral Debridement, Graft Fusion, And Instrumentation For Treatment Single Segment Of Thoracic And Lumbar Spinal Tuberculosis

Objective To explore clinical efficacy and indications of surgical treatment for single segment of thoracic and lumbar spinal tuberculosis by single posterior, intervertebral disease debridement, autogenous iliac bone graft and internal fixation.Methods A retrospective analysis our department treated single segment 62 cases of thoracic and lumbar spinal tuberculosis patients from January 2010 to January 2015, according to different surgical approach and fixed method were divided into isolated posterior intervertebral disease surgery group(experimental group, A group) and posterior and anterior combined intervertebral disease surgery group(control group, B group). The operative time, blood loss, hospital stay, Erythrocyte sedimentation rate(ESR), C-reactive protein(CRP), improvement of neurological function, VAS score, vertebral Cobb angle, bone healing and postoperative complications were observed in both groups.Results 62 patients have been followed up and follow-up time were between 10 and 30 months(an average of 22 months). It had significant statistical differences that experimental group patients of the operative time, blood loss and hospital stay were less than the control group patients(P<0.05). In the process of follow-up, the two groups patients of pain compared with pre-operation obviously improved, and the last follow-up of nervous function also were obviously recovered. Two groups patients of ESR and CRP had dropped to the normal range in postoperative six months. Within the group, preoperative, postoperative six months and the end of the follow-up of ESR, CRP were significant statistical differences(P<0.05), and between the two groups, preoperative, postoperative six months and the end of the follow-up of ESR, CRP were significant statistical differences(P<0.05). Within the group, preoperative, postoperative and the end of the follow-up of Cobb angle were significant statistical differences(P<0.05), and between the two groups of preoperative, postoperative and the end of the follow-up of Cobb angle were not significant statistical differences(P>0.05). Between the two groups, Cobb angle correction rate, angle loss were not significant statistical difference(P>0.05). The postoperative six months bone healing rates were 81.58% and 84.21% and the postoperative one year bone healing rate were 94.73% and 97.37%, respectively, between experimental group and the control group patients. The bone healing rate were not statistically significance in both groups. The complication rate of experimental group was less than the control group, which were 7.14% and 25.71% respectively, and the difference was statistically significant(P<0.01).Conclusion The single segment thoracic and lumbar tuberculosis were cured by single posterior, intervertebral disease debridement, autogenous iliac bone graft and internal fixation, and its clinical efficacy was satisfied with less complications.