Analysis Of Medium And Long Term Curative Effects Of Percutaneous Minimally Invasive Surgical Treatment Of Lumbar Spinal Tuberculosis

Objective:To explore the application value of minimally invasive surgery in the treatment of lumbar spinal tuberculosis,so as to provide reference for clinical treatment of spinal tuberculosis.Methods:Retrospective analysis of our hospital from January 2005 to December 2014,252 cases of patients with lumbar spinal tuberculosis treated with conservative treatment invalid.Among of them,228 patients were followed up for a long time On the basis of systemic application of antituberculosis chemotherapy on the receiving tube simple local chemotherapy percutaneous placement lesions(group A)142 cases.percutaneous perfusion drainage and local chemotherapy(group B)40 cases underwent percutaneous puncture catheter debridement combined with local chemotherapy(group C)30cases,percutaneous debridement and internal fixation combined with local chemotherapy catheter(group D)16 cases.Accept the follow-up of 25~126 months,an average of 68 months,Records of patients before and at the end of the follow-up of erythrocyte sedimentation rate(ESR),visual analogue scale(VAS),Oswestry disability index(ODI)score and according to the modified Macnab criteria to evaluate the overall functional recovery of patients satisfaction at the end of the follow-up.Results:Of the 252 patients,228 were followed up and 214 patients achieved clinical cure.No complications were found in all patients during treatment(retrograde infection and cross infection).Generally speaking,ESR at the last follow-up has dropped to(7.26±3.43)mm/h was statistically significant(T= 35.06,P = 0.023)compared with(44.96±12.42)mm/h of preoperative.The VAS,ODI at the last follow-up was(0.72±0.73)and(34.7 ± 15.3)% respectively,which were significantly improved than those before operation,which were(7.78±1.73)and(58.7±12.8)% respectively.The differences were statistically significant(Z= 13.641,P= 0.032;Z= 6.806,P = 0.012).According to the improved Macnab criteria,the overall satisfaction rate was 84.92(214/252)% at the last follow-up.Conclusion:According to the stepped care and personalized treatment,preoperative comprehensive evaluation of lumbar tuberculosis patients after interventional and minimally invasive treatment,most patients can achieve long-term stability and a better clinical efficacy.