Selection Of Surgical Treatment And Efficacy Analysis Of Spinal Tuberculosis In Older Patients

Objective: To investigate the selection of surgical treatment and efficacy analysis of spinal tuberculosis in older patients. Methods: Retrospectively analyses our 98 senile spinal tuberculosis patients treated with focal debridement、bone graft fusion and internal fixation from Jan, 2010 to Jan,2015, 54 cases of which were followed up effectively(30 male cases,24 female cases, age: 60-80 years, average age 66.8 years, case history: 1-48 months, average 8 months).Grouping by different operation methods: A group(29 cases) was treated with anterior debridement、bone grafting and anterior fixation procedure; B group(16 cases) was treated with posterior debridement、bone grafting and internal fixation procedure; C group(9 cases) was treated with anterior debridement、bone grafting and posterior internal fixation procedure. Through comparison of intraoperative blood loss, operation time, hospitalization time, Cobb angle, erythrocyte sedimentation rate(ESR) and according to Frankel grading method to evaluate the postoperative neurological recovery of postoperative thoracic and lumbar back pain and activity and to understand the curative effect of three groups of cases postoperatively. Results: All patients’ incisions were primary healing without formation of chronic sinus tract. All patients were followed-up 12-60 months(average 28 months).The mean operation time、average blood lose and mean inhospital time in group A were 128.2 min 、283.50 ml and 14.2 days, in group B were 148.3.0 min、247.0 ml and14.75 days, and in group C were 180.0 min、389.0 ml and 18.75 days. The improvement of preoperative Cobb angle was great in 3 groups after treatment, there was statistical significance compared with preoperative level(P<0.05), but there were no significant differences between 3 groups in Cobb angle and pre- and postoperative ESR level(P>0.05). Comparison between 3 groups, groups A and B have less operation time, blood lose and hospitalization time than group C(P<0.05), but there was no significant differences between A group and B group(P>0.05). Conclusion: In the study three kinds of surgical treatment of senile spinal tuberculosis has achieved good therapeutic effect. Using different fixation methods, as long as the indications are correct, can effectively remove the lesion, reconstruction of spinal stability, correcting deformity and achieve satisfactory treatment effect.