Abstract
BackgroundTo compare the diseased verses the non-diseased intervertebral surgery used in the treatment of thoracolumbar and lumbar spinal tuberculosis and to explore the best choice of fusion of fixation range.MethodsTwo hundred twenty-one patients with thoracolumbar and lumbar tuberculosis were categorized into two groups. One hundred eighteen patients underwent the diseased intervertebral surgery (lesion vertebral pedicle fixation, Group A) and 103 patients underwent the non-diseased intervertebral surgery (1 or 2 vertebral fixation above and below the affected vertebra, group B). Spinal tuberculosis diagnosis was confirmed in both groups of patients before lesion removal, bone graft fusion, and internal fixation. Clinical data and efficacy of the two surgical methods were then evaluated.ResultsThe mean follow-up duration for both procedures was 65 months (50–68 months range). There were no significant differences in laboratory examinations, VAS scores, and the Cobb angle correction rate and the angle loss. However, significant differences existed in the operation time, blood loss, serosanguineous drainage volume, and blood transfusion requirement between the two groups. The diseased intervertebral surgery group performed significantly better than the non-diseased intervertebral surgery group in all of these areas. In both cases, the bone graft fused completely with the normal bone by the last follow-up, occuring at 50–86 months post surgery.ConclusionThe diseased intervertebral surgery is a safe and feasible option for the treatment of thoracolumbar and lumbar tuberculosis. It effectively restores the physiological curvature of the spine and reduces the degeneration of adjacent vertebral bodies in the spinal column.
Highlights
To compare the diseased verses the non-diseased intervertebral surgery used in the treatment of thoracolumbar and lumbar spinal tuberculosis and to explore the best choice of fusion of fixation range
A typical surgery protocol includes removal of the spinal tuberculosis lesions followed by autologous bone defect repair and lastly, internal fixation to restore the biomechanical stability of the spine [6, 7]
We retrospectively evaluated the clinical efficacy of the diseased intervertebral surgery verses the non-diseased intervertebral surgery in the treatment of thoracolumbar and lumbar tuberculosis at the Department of Spine Surgery in the General Hospital of Ningxia Medical University in Ningxia, China
Summary
To compare the diseased verses the non-diseased intervertebral surgery used in the treatment of thoracolumbar and lumbar spinal tuberculosis and to explore the best choice of fusion of fixation range. The fixation and fusion methods mentioned above may meet the biomechanical requirements of the spine, they often sacrifice the normal motor units of the spine, leading to the degeneration of adjacent segments and the occurrence of chronic lower back pain [10]. It is, crucial to consider reducing the fixation range while maintaining the mechanical strength of the reconstructed spine
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