| Objective To investigate the long-term clinical and radiographic outcomes and quality of life(QoL)of patients with lumbar tuberculosis more than 10-year follow-up after operation.Methods A retrospective analysis was performed on clinical data of 70 patients who were diagnosed and accepted surgical treatment for lumbar tuberculosis from January 2002 to January 2010.The average age was 33.39 ± 14.70 years(8-56 years).The patients were followed up for at least 10 years.There were 31 males and 39 females.Regular antituberculosis treatment was carried out before and after the operation,and the patients are followed up regularly(every month for half a year,every year for five years and the 10 th year after operation).According to the scope and extent of tuberculosis focus removal,all cases were divided into complete focal debridement group(group A)36 cases and non-complete focal debridement group(group B)34 cases.The angle and angle loss of Cobb were measured before operation,immediately after operation and at the last follow-up respectively,and the neurological function status,SRS-22 questionnaire were evaluated before and at the last follow-up.And complications and bone graft healing were evaluated at the last follow-up.Results All patients who were followed up had an average follow-up of 169.26 ± 24.17months(120-216 months).The quality of life of all patients was significantly improved in the last follow-up,and their satisfaction was good.There was no significant difference in the quality of life scores between the two groups(P> 0.05).The Cobb angles of patients in group A before surgery,immediately after surgery and last follow-up were 23.60 ± 0.21,1.17 ± 6.78,2.57 ± 6.78,respectively,and the correction angle is 23.17 ± 6.80,the loss angle is 1.94 ±0.66;The Cobb angles of patients in group B before surgery,immediately after surgery and last follow-up were 24.35 ± 10.17,2.31 ± 7.67,4.07 ± 7.53,respectively,and the correction angle is 22.04±6.05,the loss angle is1.76±1.03,the postoperative Cobb angle correction was satisfactory in the two groups,with significant statistical significance(P <0.05),but there was no statistical difference in the measured angles between the two groups at each time period(P> 0.05);During the follow-up period,2 patients in group B were hospitalized again due to recurrence,and 1 patient developed pelvic tuberculosis in the 8th year after operation.At the last follow-up,21 patients were found to have adjacent segment degeneration(ASDeg)in the imaging examination,of which 5 patients had progressed to adjacent segment degeneration disease(ASDis),22 patients with chronic pain in the iliac bone removal area,and 25 patients with low back pain after tiredness.The ASIA score of neurological function in all patients had grade E except 5 patients had grade D with ASDis at the last follow-up.Bone graft healing in patients with intervertebral bone grafts achieved Grade I bone healing according to Bridwell criteria.Conclusion On the premise of standardized antituberculosis treatment throughout the course,both complete and non-complete debridement surgery have good long-term effects,but complete debridement surgery has the advantages of short cure time,fast recovery and ultra-short-term chemotherapy after surgery. |
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