Comparative Analysis Of The Efficacy Of A Transverse Process Bone Graft With Other Bone Grafts In The Treatment Of Single-segment Thoracic Tuberculosis

Objective: To investigate the clinical efficacy of three types of bone graft fusion in the treatment of single-segment thoracic tuberculosis:transverse process bone grafting alone using a posterior approach,autologous iliac bone grafting,and titanium mesh implantation.Methods: A total of 94 patients with single-segment thoracic tuberculosis who were treated with simple posterior-approach debridement,bone graft fusion,and pedicle screw and rod fixation were enrolled in this study,including 46 males and 48 females with an average age of 46.1(18-74)years and an average disease duration of 22.4 months.Among them,30 patients were treated with transverse process bone graft fusion and internal fixation(group A),28 patients were treated with autologous iliac bone grafting and internal fixation(group B),and 36 patients were treated with titanium mesh implantation and internal fixation(group C).The operative time,intraoperative blood loss,postoperative drainage amount,postoperative complications,length of hospital stay,erythrocytesedimentation rate(ESR),C-reactive protein(CRP)level,visual analog scale(VAS)score for back pain,Oswestry dysfunction index(ODI),intervertebral height,and time to bone graft fusion were compared between the groups.Changes in the Cobb angle of kyphosis,intervertebral height,and loss to the final follow-up were measured.Neurological function recovery was evaluated according to the criteria of American Spinal Injury Association(ASIA).The above parameters were compared to investigate differences between the four types of bone graft fusion.Results: All 94 patients completed the follow-up,which lasted between nine and 40 months,with an average of 19.2 months.The operative times in groups A was significantly shorter than those in groups B and C(P<0.05).No significant differences were found between C and D(P>0.05).The intraoperative blood loss in groups A was significantly less than that in groups B and C(P<0.05).No significant differences in blood loss were found between groups C and D(P>0.05).The bone graft fusion time was 7.3±2.1 months in group A,7.0±2.6 months in group B,8.4±3.1months in group C,and 7.5±3.4 months in group D.The fusion time:no significant differences were found between groups A,B,and C(P>0.05).The VAS score,ODI,ESR level,CRP level,Cobb angle of kyphosis,and intervertebral height of the affected segment were significantly improved compared with those before surgery(P<0.05).At the final follow-up,the postoperative Cobb angle of kyphosis and intervertebral height wereslightly lost,but no significant differences were found compared with those immediately after surgery(P>0.05).No serious complications were reported in the four groups.Conclusion: For the treatment of single-segment thoracic tuberculosis,the new interbody fusion technique using transverse process bone grafting is more convenient than using conventional bone grafts,with shorter bone grafting time,less blood loss,and a similar fusion time,thus representing a safe,reliable,effective,and ideal bone grafting method.