Analysis Of The Mid-term Efficacy Of Posterior Transpedicular Debridement, Anti-tuberculosis Drug Bone Cement Mixture Implantation, And Pedicle Screw Fixation For Spinal Tuberculosis

Objective:To explore the mid-term efficacy of posterior transpedicular debridement,anti-tuberculosis drug bone cement mixture implantation,and pedicle screw fixation for spinal tuberculosis.Methods: From January 2011 to June 2014,21 cases of spinal tuberculosis patients who underwent posterior transpedicular debridement,anti-tuberculosis drug bone cement mixture implantation,and pedicle screw fixation were retrospectively analyzed.Recorded the sagittal Cobb angle(the angle formed by the intersection of the extension line of the upper end plate of the vertebral body and the lower end plate of the inferior vertebral body),Bone graft fusion,erythrocyte sedimentation rate(ESR)?C-reactive protein(CRP),Visual Analogue Score(VAS),ASIA classification of preoperative,discharge and postoperative follow-up.Postoperative recurrence and complications were also recorded.According to multiple postoperative follow-up results to explore the effect of posterior transpedicular debridement,anti-tuberculosis drug bone cement mixture implantation,and pedicle screw fixation for spinal tuberculosis.Results: All patients were followed up for more than 18 months.All of the patients achieved clinical healing and no recurrence.Two cases did not get fully fusion after 3 months of operation,but there was no loosening,rupture or prolapse of the bone graft.The fusion rate was 90.9%,and all got fully fusion after 6 months of operation.The corrected kyphosis Cobb's angle was(12.61 ± 3.06)°,the difference was statistically significant between preoperation and discharge(P <0.01).Cobb's angle loss at the final follow-up was(1.52 ± 0.79)°,the difference was statistically significant between discharge and the final follow-up(P <0.01);VAS decreased from preoperative(6.00 ± 0.78)points to(2.57 ± 0.51)points at discharge,the difference was statistically significant(P <0.01),The last follow-up was(1.05 ± 0.22)points,the difference was statistically significant between discharge and the final follow-up(P <0.01);ESR and CRP were significantly lower than preoperation,but were still slightly higher than the normal vale.ESR and CRP were within normal range during each follow-up.There were 13 cases of spinal cord injury.At the last follow-up,the neurological function of 1 case with ASIA grade B recovered to grade C,3 cases with grade C recovered to grade D,2 paitients of 9 cases with grade D were still in grade D and the other 7 cases recovered to grade E.The neurological function improvement rate was 84.6%.Conclusion: The operation of posterior transpedicular debridement,anti-tuberculosis drug bone cement mixture implantation,and pedicle screw fixation for spinal tuberculosis has advantages of correction of kyphosis,low loss of Cobb Angle,high rate of pain remission,high fusion rate of bone grafting,low complication,and good neurological function recovery.