Radical Debridement , Bone Graft Fusion And Internal Fixation Surgical Approach And Effect Evaluation For The Treatment Of Spinal Tuberculosis

Objective: Analysis the thoracic and lumbar spinal tuberculosis and its corresponding three surgical approach,analysis the advantages and disadvantages of different approaches,determination of spinal tuberculosis in different parts of the surgical approach.Methods In this study,spine surgery in our hospital from January 2008 to January 2015,our hospital 90 cases of patients with spinal tuberculosis,basi s on admission patient be different ways of operation,according to the application procedure by divided the patients into three groups,one group of 28 cases,the only approach male 13 cases,15 cases were female,mean age 46.26 ±10.07 years old,7 cases of thoracic spine,lumbar spine in 11 cases,10 cases of thoracolumbar,neural function grade of ASIA: A level 1 case,class B in 3,grade C in 5 cases,D 9 cases,E 10 cases;Jobs before and after formed 32 cases,18 cases of male,female 14 cases,mean age 43.79 ±9.18 years old,6 cases thoracic vertebra,lumbar 17 cases,10 cases of thoracolumbar,neural function grade of ASIA: A level 2 cases,4 cases were B,C grade 7 cases,D 9 cases,E 10 cases.Just before 30 cases,14 cases of male,female 16 cases,mean age 44.86 ±11.22 years,8 cases of thoracic spine,lumbar spine 10 cases,12 cases of thoracolumbar,neurologic ASIA classification: A level 1 case,class B in 3,grade C 8 cases,8 D,E 10 cases;According to medical records to patients after operation time,blood loss,Cobb Angle and height of vertebral body reconstruction,hospitalization days,recovery of neural function,preoperative ESR and CPR after operation,postoperative VAS as evaluation indexes.Results In different spinal surgery,in the comparison of the joint into the road group before and after the operation time,the hospitalization days,the bleeding and vertebral body height reconstruction significantly higher than the former into the road and into the road after group(P < 0.05),the former into the road and into the road after the group to compare the above indicators no significant difference(P > 0.05),in the aspect of Cobb Angle statistical difference between the three groups have no difference(P > 0.05).On neural functional recovery and VAS,obviously improved compared with preoperative,postoperative between three groups was statistically significant difference(P < 0.05).In terms of the ESR and CRP,there was no statistically significant difference compared in three groups(P > 0.05),between the three groups in the preoperative and postoperative six compared with,the last follow-up,postoperative 6 and the last follow-up is compared with the preoperative difference was statistically significant(P < 0.05).Conclusion anterio r approach methods suitable for front vertebral body was destroyed,and along with the abscess in front of vertebral body,posterior approach suitable for vertebral body rear was serious damage,and form kyphosis deformity and rear fistula,the combined approach is suitable for vertebral serious damage more than three,and accompanied by large abscess ahead,vertebral rear kyphosis deformity of patients obviously.