Efficacy comparison between simple posterior lesion removal particle bone graft internal fixation surgery and com-bined posterior and anterior approaches for lumbar tuberculosis
Objective To compare the curative effect difference between the simple posterior approach and the combined posterior and anterior approach for the treatment of lumbar tuberculosis,to explore the feasibility of the simple posterior lesion clearance particle bone graft internal fixation surgery.Methods A retrospective analysis was performed for 42 patients who underwent simple posterior or combined posterior and anterior surgery for lumbar tuberculosis in Hebei Chest Hospital from May 2020 to August 2022,and were divided into the simple posterior group and combined posterior and anterior group according to the surgical method.There were 24 cases in the simple posterior group,including 13 males and 11 females,aged 22-80 years.There were 18 cases in the combined posterior and anterior group,including 10 males and 8 females,aged 17-69 years.The operation time,intraoperative blood loss,postoperative bed rest time,ESR and CRP were compared between the two groups.Low back pain and functional recovery were assessed using the Pain Visual Analogue Scale(VAS)and the Oswestry Dysfunction Index(OD1).The degree of Cobb Angle correction,the degree of loss at 1 year and the postoperative fusion time were compared between the two groups.Bridwell bone fusion criteria and CT bone fusion criteria were used to evaluate bone fusion.Results The operation time of the simple posterior group was lower than that of the combined posterior and anterior group(t/P=5.995/＜0.001).The intraoperative blood loss in the posterior group was lower than that in the combined posterior and anterior group(t/P=2.134/0.039).The postoperative bed time in posterior group was lower than that in the combined posterior and anterior approach group(t/P=5.835/＜0.001).There were signifi-cant differences in ESR and CRP between 2 groups 6 months after operation and before operation(P＜0.01).VAS and ODI scores before surgery and 1 year follow-up was compared between the two groups,and there was significant statistical sig-nificance(P＜0.01).There was no significant difference between the two groups(P＞0.05).There was no significant differ-ence in the degree of Cobb Angle correction,the degree of loss one year after surgery and the time of fusion between the two groups(P＞0.05).There was no significant difference in the fusion rate of bone graft between the two groups according to Bridwell fusion criteria and CT bone fusion criteria(P＞0.05).Conclusion Both the simple posterior approach and the combined posterior and anterior approach can obtain satisfactory results in the treatment of lumbar tuberculosis.The treat-ment of lumbar tuberculosis by simple posterior lesion removal particle bone graft internal fixation surgery is safe and feasi-ble,and has achieved good clinical efficacy.simple posterior lesion removal particle bone graft has the advantages of short operation time,less bleeding and less trauma.
Lumbar tuberculosisSimple posterior approachCombined posterior and anterior approaches particle bone graftingClinical efficacy
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