Selection Of Surgical Procedures For The Treatment Of Spinal Tuberculosis

Objective: To summarize advantages and disadvantages of spinal tuberculosis operation methods by retrospective studying 98 thoracic-waist-sacral vertebrae tuberculosis cases with operation therapy of my hospital in recent years.Method: We treated 126 thoracic-waist-sacral vertebrae tuberculosis cases by operation from Jan ,2001 to Jun,2007,98 cases of which were followed up effectively(53 male cases ,45 female cases, age: 16--76years, average age 39.6 years, case history :3--39 months, average 15 months). Grouping by different operation methods'group(21 cases) was used simple clearance of focal lesion, B group(16 cases) focus clearance combining bone graft fusion and property internal fixation group(49 cases)Ⅰproperty focus clearance and post path bone graft fusion combining internal fixation as well as D group(12 cases) simple post path bone graft fusion combining pedicle of vertebral arch internal fixation.Result: All patients'nicks were primary healing without formation of chronic sinus tract.98 cases were followed up 6～72 months (average 33).75 cases with post crypto-deformity were reacted for 18.3 degrees but loss 3-5degrees in the following up terms. All cases were obtained one–time curing other than two-time curing of 2 cases in the A group .45cases with obvious nervous lesion were significant improved. Comparisons between groups were used with chi square. The time and bleeding volume of operation of A/D groups were less than those of B/C groups.Conclusion: Spinal stability has significance in the process of treating spinal tuberculosis on condition of effective anti tuberculosis chemotherapy. The operations of simple post path pedicle of vertebral arch internal fixation and post lateral spinal fusion can treat spinal tuberculosis with nervous lesion effectively, which have merits of slight surgical trauma and easy to carry out.