Posterior Wedge Osteotomy, The Order Of The Multi-rod Orthopedic Fixation And Fusion In The Treatment Of Severe Tuberculous Spinal Deformity Efficacy Analysis

Objective: Explore the posterior wedge osteotomy, the order of the multi-rodorthopedic fixation and fusion in the treatment of severe tuberculous spinal deformityclinical efficacy, safety, and surgical precautions. Methods: Diagnosis and treatment ofspinal tuberculosis in patients of our hospital from2005to2010750cases, of whichcomplete clinical data and follow-up information in50patients with severe tuberculouskyphosis or kyphoscoliosis deformity:35females,15males were takenRoad wedgeosteotomy, the multi-rod sequence orthopedic fixation and fusion surgery.Aged9to62years old, average31.65years old. Malformation located in the30cases of thoracic,thoracolumbar in10cases,10cases of lumbar spine. Accumulated two cone three cases, atotal of3to5cone42cases,5cases accumulated more than five cone. ASIA gradepreoperative neurological function as a Class B two cases,23cases of class C, Grade D,25cases were taken to the posterior wedge osteotomy, how cool is the order of orthopedicfixation and fusion surgery. The preoperative, postoperative, and follow-up photo standingfull-spine X-ray film, to measure sagittal, coronal, thoracic kyphosis, lumbar lordosis,Cobb angle, recording spinal fusion fixed segments, and fusion. OUTCOME MEASURES:The preoperative and postoperative Cobb angle; ASIA classification of neurologicalfunction and sensory and motor function score; VAS scores; Beaujon-Lassale score;imaging data (X-ray); postoperative appearance of the life and work to improve conditionsand complications occurrence.Results: The patients were followed up for12to62months,an average of28.8months.Fusion fixed bamboo segments9and16vertebrae, with anaverage of11.8. The operative time was195~420min, an average of290minutes,1100~3300ml of blood loss, an average of1800ml. The postoperative results were satisfactory, 40cases as excellent,10cases of good, no serious complications of spinal corddysfunction were significantly improved. Thoracic kyphosis from preoperative17.15°corrected to a postoperative average of19.25°, the average thoracic kyphosis correctionof36.1°. Lumbar lordosis corrected from an average of67.2°preoperative to thepostoperative average of36.8°, lumbar lordosis, an average correction of30.4°. SagittalCobb angle from the preoperative average of107.1°corrected to a postoperative averageof29.25°, the correction rate of74.6%. The coronal Cobb angle from an average of11.55°preoperative correction to postoperative average of0.6°, the average correction of thecoronal Cobb angle of10.95°. Clinical symptoms are more pronounced improvement inthe ASIA classification of neurological function and sensory, motor function, the BL scoreand VAS score significantly improved, including VAS improvement: excellent:13cases,good:35cases can be: two cases. Postoperative ASIA scale of1case of grade C, D in13cases,36cases in E-Class. Circumference between the operation of major complicationsincluding eight cases of gastrointestinal dysfunction, intraoperative laminar fracture in3cases,13cases of pleural damage, the second operation in five cases.Conclusion:Posterior wedge osteotomy, the rod sequence orthopedic fixation and fusion surgery threecolumn spine bone contact, fusion rate, less loss of follow-up point of view, the degree ofcorrection is reliable, the orthopedic effect, have a more significant improvement inclinical symptoms, surgeryafter the patient’s neurological function ASIA grade andsensory and motor function score, VAS scores significantly decreased the BL functionscore significantly higher than before, the complication rate is low, the availability ofadequate preoperative assessment and meticulous surgicaloperation, the treatment ofsevere tuberculous spinal deformity a relatively safe, effective, reliable operation。...