| Objective:To investigate the clinical efficacy of the road after clearing tuberculosis, bone fusion, fixation of thoracolumbar pedicle screw tuberculosis and to evaluate its safety and efficacy.Method:A retrospective analysis of January 2011 - January.2014 period Liuzhou People’s Hospital, thoracic and lumbar spine surgery treated TB cases, patients were treated with posterior approach tuberculosis Clear interbody fusion treatment, preoperative and postoperative specification TB drug treatment. Patients were collected before surgery, and follow-up erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), pain visual analogue scale (VAS), Oswestry Disability Index (ODI), Cobb’s angle and related neurological conditions fusion evaluation after 1 year and last follow-up and clinical efficacy were observed loosening situations; data. Data results were analyzed by SPSS18.0.Results:The study group operative time was 110-210 (138 ± 48) min, blood loss 300～1200 (423±52) ml. One case of skin flap necrosis,1 case of tuberculosis sinus, no cases of intraoperative and postoperative mortality and neurological injury aggravated. All patients were followed up, no shedding up for 15～36 (18.7±5.3) months. Preoperative ESR is (47±10.2) mm / h, after six months in all patients ESR returned to normal, as (8.0±3.1) mm /h, ESR before surgery, in January, March and June a statistically significant difference between (F=125.470, P=0.001); preoperative CRP was (38.8± 9.1) mg / L, all patients after three months CRP returned to normal, as (9.7± 4.7) mg / L, CRP before surgery, in January, March and June among a statistically significant difference (F=79.050, P=0.000); preoperative VAS score was (6.8±1.6) points, a significant decrease in January after It was (2.6 ±1.2) points, VAS score before surgery, in January, March and June, a statistically significant difference between (F=17.664, P=0.016); ODI score before surgery was (39.1±12), to the end of follow-up, improved to (6.8± 2.5), to improve the rate of 82.6%, compared with the preoperative improved significantly, ODI score before surgery, in March, June and last follow-up between the difference was statistically significant (F=98.073, P= 0.004); The preoperative Cobb angle of the convex (23.3 ± 5.2) °, after a month (8.7 ± 2.1) °, the average correction of 14.6 °, correction was 62.6%, preoperative and After 1 month Cobb’s angle was statistically significant (t=3.92, P=0.006); the last follow as (11.6±3.0)°, the average loss of 2.9°, preoperative and last follow-up Cobb’s horns statistically significant (t=2.32, P=0.031), after 1 month follow-up compared with the end of the projection Cobb angle was no significant difference (t=0.38, P=0.705); the presence of 17 cases of preoperative neurologic injury (B grade two cases, C grade three cases, the rest are Class D), except one case to last follow-ASIA grade of D grade, the rest were returned to the E-Class; all patients were within eight months have received bone graft fusion, fusion time is 3～8 (5.1±1.4) months, and 1 year after the last follow Bridwell I and Level II fusion rate was 89% and 96%, respectively. All patients were 9～14 (11±1.7) months to obtain clinical cure, and at 1 year after the end of the follow-up clinical evaluation excellent rate of 91% and 96%, respectively. There were no follow-up to the last screw loosening, titanium rod screw breakage, loose graft prolapse or the collapse occurred.Conclusion:Debridement posterior interbody fusion and internal fixation of thoracolumbar spinal tuberculosis, trauma, less bleeding, fewer complications spinal tuberculosis relative sense "minimally invasive" surgery, to meet local tuberculosis clear and thorough and effective spinal decompression, reconstruction and fusion lesions and three columns strong stability purposes kyphosis correction after the effective prevention of kyphosis correction and improve neurological function, is a safe and effective surgical methods. |
PDF Full Text Request