| Objective: to analysis the phase of the posterior lesions cleared titanium cage filled with autologous bone graft and simple autologous bone graft in bone graft fusion and internal fixation treatment thoracolumbar tuberculosis clinical effect.Methods: A retrospective analysis in October 2015 to December 2017 in lanzhou university orthopaedic line issue of posterior lesions cleared bone graft fusion and internal fixation treatment of 69 patients with spinal tuberculosis,including titanium cage bone graft fusion group(group A)34 cases and simple autologous bone graft fusion group 35 cases(group B).Observing two groups of operation time,blood loss,hospital stay,hospital expenses and spinal cord function before and after operation Frankel classification,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP)and partial protrusion deformity after Cobb Angle correction,bone graft fusion time,visual analogue scale(VAS)is analyzed and compared.Results: all patients with postoperative pathological examination confirmed tuberculous,follow-up time 4 to 24 months(mean follow-up time 15.4),all patients at the time of the last follow-up to achieve bony fusion,two groups of patients with postoperative Cobb Angle were obviously improved compared with preoperative,no statistical signif icance between groups(p > 0.05),postoperative follow-up of 1 year when Cobb Angle lost less than group B,group A was statistically significant(p < 0.05),two groups of postoperative nerve function more preoperative improved markedly.In the two groups of patients did not relaps e.Postoperative fracture of internal fixation,complications such as pseudarthrosis formation and bone graft of osseous fusion time,A group of 4 to 12 months,on average,8.2400±2.14 months,group B 7.90-13 months,an average of 7.92± 2.25 months,there w as no statistically signif icant difference between(P > 0.05).In the protrusion deformity Cobb Angle on the group A point of 29.52 ± 6.62 preoperatively,postoperatively point of 19.43±6.71,9.50 ± 8.76 °,group A correction on average 9.76 ± 6.94 °,followed up for 19.49 ± 7.01 at the end of the time,lost Cobb Angle 2.16 ± 4.65 °.Group B Angle 30.12 ± 6.71 preoperatively,Angle of 19.11 ± 6.05 postoperatively,group B average correct 9.34 ± 7.56 °,followed up for 23.68 ± 9.65 at the end of the time,lost Cobb Angle 3.43 ± 5.69 °.Convex after postoperative neurologic improvement,corrective Angle on the two differences have no statistical signif icance(P > 0.05),lost the last follow-up Angle was lower than those of group B,group A statistically significant(P < 0.05).153.51 ± 34.62 min average surgery time of group A,group B 183.64 ± 42.62 min and 18.44 ± 5.35 days,the average hospitalizat ion time of group A group B was 19.68 ± 6.53 days,operation time on the difference between two groups was statistically s ignificant(P < 0.05),the length of time has no obvious statistical signif icance(P > 0.05);The average intraoperative blood loss of group A was 543.50 ± 263.46 ml,group B 742.61 ± 325.69 ml,the comparison was statistically signif icant(P < 0.05).Group A mean of 58.42 ± 16.58 mm/h preoperative blood sedimentation,postoperative 1 week blood sedimentat ion,on average,26.23 ± 14.58 mm/h,3 months after blood sedimentat ion,on average,15.72 ± 8.35 mm/h,B group of preoperative blood sedimentat ion,on average,57.54 ± 17.29 mm/h,postoperative 1 week average 25.98.02 blood sedimentat ion/h ± 16.74 mm,3 months after blood sedimentation,on average,15.54 ± 7.98 mm/h,two groups in the preoperative and postoperative 1 week and 3 months after ESR differences point no statistical significance(P > 0.05),postoperative 1 week and 3 months after the ESR obviously improved than before,but the difference was statistically significant(P < 0.05).Conclusion:(1)posterior lesions cleared bone graft fusion and internal fixat ion in treatment of spinal tuberculosis is effective,safe and reliable.(2)filling bone graft titanium mesh compared with pure autogenous bone graft fusion and bone graft fusion time has no obvious difference,but satisfied,titanium cage bone graft support strength with internal fixat ion device can effectively correct protrusion deformity after reconstruction of the biological stability of the spine,can reduce the Cobb lost late surgery. |
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