Comparison Of Effectiveness Between TLIF And Anterior-posterior Surgery In Treatment Of Lumbar Brucella Spondylitis

Objective To investigate the efficacy of transforaminal approach debridement with fusion,thoracolumbar single segment of Brucella spondylitis pedicle screw fixation(TLIF surgery)treatment.Methods A Retrospective analysis of January 2009-January 2014 our department with TLIF surgery(group A)and internal fixation with a simple posterior anterior interbody disease debridement,autogenous bone graft(B group)treated 28 patients met the surgical indication Brucella spondylitis clinical data of patients,Comparison of the two groups of operation time,blood loss,postoperative ambulation time,days of hospitalization,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),American Spinal Injury Association(ASIA)classification,visual analogue scale(VAS),Oswestry Disability index(ODI),Cobb angle of vertebral bone graft healing and complications and so on.Results All patients were followed for an average time of 20.2 months(18 to 27 months).All patients were cured,compared with group B,A group of patients with operation time(164.60±59.19 min),significantly reduced blood loss(346.00±108.90 ml)and complications(1 case);postoperative ambulation time(3.36?1.11 day),hospitalization(17.36±4.19 day)and duration(13.16±3.94 month)was significantly shorter,and the difference between the two groups was statistically significant(P <0.05).The preoperative VAS scores of A and B groups were statistically significant compared with that of 3 months after operation(t = 26.604,P = 0.000;t = 25.289,P = 0.000).There was significant difference in the preoperative ODI between the two groups(t = 36.693,P = 0.000;t = 35.964,P = 0.000).To ESR in group A and B,The significantly different was that in March after operation(t = 20.388,P = 0.000;t = 22.146,P = 0.000).And CRP.(t = 18.231,P = 0.000;t = 19.435,P = 0.000).The malformations of the two groups were corrected after operation.There was significant difference in the preoperative Cobb between group A and the last follow-up(t = 14.329,P = 0.000;t = 11.524,P = 0.000)Compared with postoperative and final follow-up,the difference was statistically significant(t = 15.447,P = 0.000;t = 15.103,P = 0.000).All patients had significant improvement in their neurological function.The ASIA grading of spinal cord nerve function recovered from grade B to grade D in 3 patients.The level of spinal cord nerve function ASIA was recovered from grade C to grade D in one patient and the others recovered to E level.Conclusions On the basis of anti-drug treatment,The TLIF of surgery to Brucella spondylitis with an anterior debridement,interbody fusion and posterior fixation effective was equal,but the former with less trauma and bleeding,shorter operating time,easy to operate,less postoperative ambulation,less postoperative ambulation time and early complication rate.