Retrospective Analysis Of Different Surgical Methods And Outcome In Elderly Patients With Lumbar Tuberculosis

Objective: To review the clinical characteristics of senile patients with lumbar spinal tuberculosis,and discusses the choice of the ways of patients with lumbar spinal tuberculosis strategy,summarizes the different surgical approach,surgical method to contain the advantages and disadvantages of different complications of elderly patients.Methods: Between June 2005 and January 2015,125 patients(54 women and 71 men)aged 65 years or older were included in the study.The surgical methods were divided into three groups: simple anterior approach,simple posterior approach,and anterior and posterior combined operation group.According to the comprehensive assessment of patients with trauma index(operation time,intraoperative and postoperative blood loss,hospital stay,postoperative complications),imaging parameters(after the loss of the convex Angle correction rate,correction degree,osseous fusion time),and the quality of life rating scale,including Frankel classification of spinal cord injury,pain visual analogue scale(VAS)and modified Macnab criteria to comprehensive evaluation procedure for the advantages and disadvantages of different complications in elderly patients.Result:The trauma index of the surgery group was the lowest,while the combined surgery group had the highest trauma index.Simple anterior group of the protruding after spine correction rate(52%±5.45%)was lower than that in group only approach(74%±5.04%)and the combined approach group(69%±7.95%),and simple anterior group(2.5 °)and loss of correction degree was obviously higher than that of pure posterior group(0.8 °)and the joint into the road(1.1 °).The postoperative osseous fusion time was similar in 3 groups.Postoperative quality of life were significantly improved,Frankel classification according to different treatment of elderly patients have better period of nervous functions,VAS score and modified Macnab score in three groups of patients were followed up at last are improved better,and there is no difference between groups.Conclusion: Based on the retrospective study,considering the elderly patients with immune deficiency,and often merge a variety of cardiopulmonary function not entire basic diseases,for patients with simple lumbar vertebral tuberculosis,may damage the main blood vessels or the function of abdominal organs by anterior approach which should be limited.In the retrospective analysis,combined posterior and anterior approach has significant curative effect,However,considering the limited condition of patients’ tolerance to surgery,posterior operation is safer and less traumatic than anterior and combined surgery.