Efficacy Analysis Of Short Pedicle Screw Fixation Technique For Lumbar Tuberculosis

Objective To evaluate the application prospect of short pedicle screw and long pedicle screw fixation in posterior pedicle screw fixation,primary or secondary anterior lesion removal and bone graft fusion,and to compare the application effect and long-term effect in reconstruction of spinal stability.Methods Retrospective analysis was made on the data of 96 patients who were diagnosed with single-level lumbar tuberculosis and underwent surgical treatment in Ningxia Medical University Hospital from January 2008 to December 2015.According to the length of pedicle screws used for internal fixation,they were divided into short screw group(52 cases):pedicle screw length 20-35 mm and long screw group(44 cases): pedicle screw length >35mm.The general condition,laboratory examination,healing time of bone graft,cure of spinal tuberculosis,spinal function(flexion,rotation),complications and other indexes of patients in the two groups were compared.Cobb Angle of each group was measured before,after and at the last follow-up,and the correction Angle and loss rate were calculated to evaluate the correction effect of spinal deformity.Results All patients were followed up for 60 to 127 months,with an average of 87.6months.There were no significant differences in ESR,CRP and VAS scores between the two groups during the same period(P > 0.05),but there were significant differences between the two groups before and three months after surgery(P < 0.05).The anterior bone grafts were fused successfully in both groups.The fusion time of short screw group was 4.54 ± 1.24 months,while that of long screw group was 4.39± 1.13 months.There was no significant difference between the two groups(P > 0.05).All cases were cured,and no serious complications such as tuberculosis recurrence,failure of internal fixation and nonunion of bone grafts were observed during the follow-up period.There was no significant difference in Cobb Angle between the two groups in preoperative,postoperative and final follow-up.In the short nail group,the corrected Angle was 15.81°±2.85°,the missing Angle was 1.96°±0.93°,and the loss rate was(13.40±9.31)%.In the spike group,the corrected Angle was15.07°±3.91°,the lost Angle was 1.84°±0.83°,and the loss rate was(13.74±10.13)%.There were no significant differences in the correction Angle and loss rate of kyphosis between the two groups(P > 0.05),but there were significant differences in Cobb Angle between preoperative and postoperative,preoperative and last follow-up within the two groups(P < 0.05).Conclusion Short pedicle screw fixation technique in the treatment of single-level lumbar tuberculosis can rebuild the stability of the spine and achieve the same fixation effect as long pedicle screw,and the follow-up results are satisfactory.