| Objective: To investigate the clinical efficacy of simple anterior approach and posterior approach of tuberculosis debridement bone grafting and instrumentation for the treatment of single-segment thoracic spinal tuberculosis.Methods: Retrospective analysis of 41 patients with single-segment thoracic vertebral tuberculosis treated from January 2013 to December 2015 in our hospital.Simple anterior focus debridement and bone graft fixation was used to treat 21 cases.Simple posterior focus debridement and bone graft fixation was used to treat 20 cases,two groups of patients were given standard anti-tuberculosis treatment for two to three weeks before operation.Record the operation time,blood loss during surgery,hospitalization days,bone fusion time,complication rate,and erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),Cobb angle,and American Spinal Injury Association impairment scale(ASIA).Results: All the operations were completed successfully.The follow-up was 12~18 months after the operation,and the average follow-up was 14 months.There was no statistically significant difference in operative time,intraoperative blood loss and hospital stay between the two groups before and after operation.There was no statistically significant difference in ESR,CRP,ASIA grading,Cobb angle correction and postoperative complication incidence before and after operation(P > 0.05).In the angle of Cobb angle loss,the anterior group was larger than the posterior group,and the difference was statistically significant(P < 0.05).At the last follow-up,all patients had bony fusion and no complications such as recurrence of tuberculosis and internal fixation loosening or rupture occurred.Conclusion: Anterior-only approach and posterior-only approach for surgically treating single segment thoracic tuberculosis can achieve satisfactory results,but compared with the anterior approach,the posterior approach is superior to theanterior approach in correction angle loss of Cobb angle. |
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