To Observe The Clinical Efficacy Of The Treatment Of Tuberculosis Of Thoracic And Lumbar Spine Under The Quadrant Minimally Invasive Treatment System

Objective:To observe the clinical efficacy of the treatment of tuberculosis of theThoracic and Lumbar Spine tuberculosis under the Quadrant Minimally invasive spinal surgeryTransforaminal lumbar interbody fusion treatment system。 Method:All patients suffered from Thoracic and Lumbar Spinal tuberculosis which were treated surgically to apply the Quadrant minimally invasive treatment system from August 2014 to October 2017 were reviewed,including 24 males and 30 females,aged 18 to 73 year olds,average 45.9years。The lesion is divided into segments of thoracic and lumbar vertebrae。 In accordance with the operation method,Fifty-four patients were divided into 2 groups randomly: 27 patients were treated with Minimally invasive spinal surgery-transforaminal lumbar interbody fusion technology under the Quadrant(MIS-TLIF Quadrant group),The other 27 patients were treated with traditional open operation(open group)。The American Spinal Injury Association(ASIA)impairment scale was used to assess the neurological fuction,including MIS-TLIF Quadrant group(ASIA grade C 1patient、grade D 19patients、grade E 7 patients)and open group(ASIA grade C 1patient、grade D 17patients、g-rade E 9patients)。The two groups were compared.Preoperative and postoperative changes in clinical symptoms,nervours function,the situation of the erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)with follow-up regularly,as well as other related complications were observed 。The spinal changing of thephy siological curvature were detected through regular imaging examination.Result:All operations were completed successfully,and were indicated tuberculosis infection of thoracic and lumbar with pathology。All the patients were followed for a mean period of 14.3 months(ranged 12-15months),and recovered well after surgery。 All the patients in the two groups have obtained the remarkable clinical recovery after the surgery.The operation time,postoperative bleeding loss,surgical incision length,hospitalization time of the quadrant group was very well compared with the traditional open group,and the difference was statistically significant(P <0.05),but There was no statistically significant difference in ambulation time follow-up of postoperation and the last follow-up of the two groups(P>0.05).The the erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP)of minimally invasive group was better than the open group in one week and three months after operation,and There was statistically significant difference between ESR and CRP(P <0.05)。Through all patients ESR and CRP returned to normal levels at the last follow-up,the inflammatory index of the quadrant group recoverd earlier and recovered faster than the open group.The average VAS pain score in two weeks and three months after operation,and JOA score,COBB angle of postoperation and the last follow-up obtained the remarkable curative effect,there were statistically significant differences compared with the preoperative measurements。For example,the JOA score of the quadrant group improvement rate was about 72.13%,among them,the JOA score showed that the total fine rate was 85.19%.According to ASIA scoring system,two patients had significant improvement at the final-follow-up: one case with Grade C had returned to D in the quadrant group,two cases with Grade C had returned to D in the open group,the rest the 51 patients with neurologic deficits before surgery had complete recovery to Grade E。 Conclusion:Under the premise of mastering the indications and contraindications.Minimally invasive spinal surgery-transforaminal lumbar interbody fusion under th Quadrant to treatThoracic and Lumbar Spinal tuberculosis can obtain the same clinical curative efficacy as the traditional open surgery,but Minimally invasive spinal surgery-transforaminal lumbar interbody fusion technology under the Quadrant has obvious advantages such as the less destruction of Thoracic and lumbar normal anatomical tissue,obviously protect vertebral muscles,less operation duration,less bleeding,quicker postoperative recovery,less pain and obvious minimally invasive.et al。Compared with the traditional open surgery,Because of these advantages,it is worth clinical promotion。the short—term outcomes is excellent,and it is safe and effective that the Quadrant minimally invasive treatment system for the treatment of tuberculosis of Thoracic and Lumbar Spine,but the long-term outcomes should be further studied clinically。...