The Curative Effect Of Partial Subhealthy Bone In The Treatment Of Multisegment Spinal Tuberculosis

Objective:bjective to investigate the curative effect of partial resection of the vertebral body(i.e.,resection of dead bone,abscess,caseous necrosis,tuberculosis granulation tissue,sclerotic wall and necrotic intervertebral disc,retaining the "sub healthy bone" outside the sclerotic wall)and traditional radical excision to normal bone for the treatment of multilevel spinal tuberculosis.Methods:otal of 92 patients with multiple spinal tuberculosis patients admitted to our hospital from June 2009 to June 2015 were collected,and 77 cases were included in this study in strict accordance with the inclusion criteria.According to whether or not the "subhealthy bone" was retained during the operation,it was divided into the reserved group(group A)and the non reserved group(group B).A group of 42 cases,male 23 cases,female 19 cases;21 cases of Uygur,16 cases of Han and Kazak 5 cases;age 12~80 years,average 45.33 years old.The course of disease was from January to 51 months,with an average of(10.47 ±3.69)months.B group of 35 cases,male 20 cases,female 15 cases;18 cases of Uygur,Han 15 cases,2 cases of Kazak;age 17~76 years,average 47.14 years old.The duration of the disease was from February to June,the average(11.35±4.65)months.Respectively on two groups of preoperative and postoperative C-reactive protein,erythrocyte sedimentation rate,hospitalization days,operation time,intraoperative blood loss,bone graft fusion time,Frankel classification,Frankel grading period,convex Cobb Angle after recovery,and bone graft fusion satisfaction rate and other indicators were analyzed.Results:roup A had less intraoperative time and intraoperative blood loss than group B(P <0.05).There was no statistically significant difference between the two groups(P>0.05).The erythrocyte sedimentation rate(ESR)in the group was significantly improved in March compared with that before operation.There was no significant difference between the two groups before operation,after March and June after operation(P > 0.05)(Table 2).The two groups of C-reactive protein group were significantly improved in March compared with those before operation.There was no significant difference between the two groups before operation,in March and in June after operation(P > 0.05).At the time of the last follow-up,Cobb Angle by preoperative(29.83±7.26)° respectively,(31.17±6.52)° correction to postoperative(15.36±5.33)°,(16.13±5.63)°.Frankel classification was effective,the group A was 95.24%,and group B was 94.29%.There was no statistically significant difference in bone graft fusion satisfaction rate(P>0.05).Conclusion:he partial resection of spinal tuberculosis vertebral body and the preservation of "sub-healthy bone" were effective in the healing and fusion of the vertebral body;Partial resection of the disease is beneficial to maintain the maximum degree of spinal activity in maintaining the stability of the spine;Individualized treatment should be chosen according to the general situation of the patients,the characteristics of the focus,the type of complications and the experience of the surgeon.