Posterior Pedicle Screw Combined With Lateral Debridement,Bone Graft For Multilevel Thoracolumbar Tuberculosis

Objective: To analyze the clinical efficacy and complications of anterior focus clearance,bone graft combined with posterior pedicle screw in the treatment of multisegmental tuberculosis of the thoracolumbar.Methods: a retrospective analysis from May 2015 to January 2017 underwent anterior debridement with autograft bone fusion combined with posterior treatment of multiple thoracolumbar tuberculosis patients in 28 cases of percutaneous pedicle screw,intraoperative hemorrhage evaluation;operation time;hospitalization;postoperative segmental kyphosis angle(segment Cobb kyphotic angle,SKA)and the loss rate of correction the rate of postoperative fusion rate;(Suk);postoperative VAS pain score,neurologic function(ASIA score),and complications(spinal cord injury,partial,partial insertion;visceral and vascular injury,the screw and the guide needle angle;internal fixation loosening)statistics and analysis.Results: 28 patients,17 males and 11 females,with an average age of(44.25 ± 16.6)years,successfully completed the operation.The operative time was(188.9 ± 32.5)min,and the average intraoperative blood loss was(599.2±80.3)ml.The patients were followed up for 7 days,1 months,3 months,6 months and 12 months after the operation.The average pain VAS score was(3.26±1.01)scores,and the average of 1 months after the operation was(1.48± 0.75)points,and the difference was statistically significant.All the patients' internal plants were safe and effective during the follow-up period,and there was no implant loosening or displacement.In 28 cases of allograft,the standard of fusion was reached at12 months after the operation.The complications included spinal nerve injury(ASIA classification),internal and partial nailing,visceral and large vascular injury,screw andguide angle,and loosening of internal fixation.Conclusion: anterior debridement after implantation of three massive allograft cortical autogeneus bone support fusion with posterior percutaneous pedicle screw fixation for the treatment of thoracolumbar tuberculosis deformity correction and fusion rate were better;percutaneous fixation of minimally invasive surgery,the recent good effect,two kinds of operation order can obtain better effect of surgery,and no incision infection,position transformation when the bone graft from complications such as severe kyphosis;choose first anterior debridement and bone block supporting tension.If combined with the anterior minimally invasive channel technique,the trauma can be further reduced.