Compare Study Of Anterior Approach Titanium Cage Rib Graft With And Iliac Bone Graft For Thoracic And/or Lumbar Tuberculosis

Objectives:To analyze and compare the efficacy of anterior approach titanium cage rib graft and iliac bone graft with titanium plate internal fixation for thoracic and/or lumbar tuberculosis.Methods:Total 57 patients with thoracic and/or lumbar tuberculosis from July 2012 to September 2016 were retrospectively analyzed.Among them,27 patients underwent titanium cage rib graft(Group A),and 30 patients underwent iliac bone graft with titanium plate internal fixation(Group B).The trauma indexes(operation time,bleeding volume,postoperative drainage volume,hospitalization time and complications),clinical efficacy evaluation indexes(pain visual analogue scale and Frenkel classification),imaging indexes(segment kyphosis,correction rate and bone fusion time)between the two groups were compared and analyzed statistically.Result:After fellow-up time for 12~7 months,the grafted bone were fused in all patients.The operation time of Group A was 143.77±26.86 min,and theintraoperative blood loss was 585.00±330.40 mL,and both of them were less than those of Group B(151.19±44.45 min,607.41±359.67mL).The postoperative drainage volume of Group A was 314.67±145.36 mL,and the length of stay was16.85±8.43 d,and the bone fusion time was 6.02±0.62 month,and all of them were higher than those of Group B(276.30±206.29 mL,14.47±8.06 d,5.99± 1.27month).There are no significant difference between the two groups(P>0.05).The preoperative Cobb angle of Group A and Group B were(25.44±8.49)° and(25.13±5.73)°.The postoperative were(13.70±6.05)° and(17.30±3.53)°.The recent were(15.63±6.55)° and(21.43±6.17)°.The indexes of Group A shows better efficacy of the improvement of kyphosis(P<0.05).The VAS score and Frenkel classification of both groups improved obviously,but no signification difference showed(P>0.05).In Group A,1 case presented with wound infection,1case presented with subaxillary hematoma,and 1 case suffered tuberculosis meningitis.In Group B,3 cases presented with wound infection,and 2 cases suffered donor site pain.The complications were healed after treatment.Conclusion:Both anterior approach titanium cage rib graft and iliac bone graft with titanium plate internal fixation have good clinical efficacy,but the former shows a better improvement of kyphosis,higher stability,and less possibility of complications in donor site.