The Clinical Efficacy Of Simple Anterior And Posterior Surgery For Thoracic Spinal Tuberculosis

Objective: To compare the clinical efficacy of simple anterior approach and posterior approach in the treatment of tuberculosis of the thoracic spine,and to investigate the choice of the two surgical methods.Methods: A retrospective analysis of 64 patients with thoracic tuberculosis treated at the Department of Orthopaedics,Affiliated Hospital of North Sichuan Medical college from January 2010 to January 2016 was divided into two groups according to the type of surgery used.33 patients in group A were treated with anterior transthoracic thoracic approach.The lesions were removed by fusion surgery and internal fixation.In group B,31 patients were treated with transthoracic pedicle approach.One-stage lesion removal,bone graft fusion,and pedicle screw system fixation were used.The average age of the anterior group was 42.8±16.3 years old,including 19 males and 14 females.Preoperative imaging examinations indicated varying degrees of bone destruction and kyphotic deformity.Frankel's grade C was 1 and D was 5 cases.The average age of the posterior approach group was 43.4±14.7 years old,including 18 males and 13 females.Imaging findings showed varying degrees of bone destruction and kyphotic deformity.Frankel's grade C was 1 and D was 4.We continued to standardize antituberculosis treatment for 1-1.5 years after surgery.We performed regular follow-up review of bone graft fusion,neurological function recovery,and kyphotic deformity improvement.We compared hospital stay time,operation time,intraoperative blood loss,and kyphosis between the two procedures.Malformation correction,correction rate,bone fusion time,postoperative complication rate and other indicators.Results: No serious complications occurred in all patients.Neurological function was restored to varying degrees.There was no significant difference in hospitalization time,bone graft fusion time,and neurological function recovery between the two surgical procedures.The anterior approach group was in operation time and intraoperatively.The amount of blood loss was better than that of the posterior surgery group(P<0.05),and the posterior approach group was superior to the anterior approach group in correction,correction rate,and correction of kyphosis(P<0.05)There were no recurrences of tuberculosis in both groups.Conclusion: Both the anterior and posterior approaches to the treatment of thoracic tuberculosis can achieve good results.The anterior approach group has advantages in the operation time and intraoperative bleeding,but the correction and maintenance of the kyphotic deformity in the posterior approach group.The superior to the anterior approach,the clinical work need to pay attention to grasp the two surgical indications,according to the patient's condition to make the choice of treatment.