| Analysis of posterior debridement with osteotomy and titanium mesh bone graft fusion in the treatment of thoracolumbar tuberculosis |
| Received:August 06, 2022 Revised:September 28, 2022 Click here to download the full text |
| Citation of this paper:DUAN Ping-guo,LIN Si-jian,FAN Rong-hao,GUO Run-sheng,MA Sheng-biao,DUAN Man-sheng,YAO Hao-qun,ZHANG Bin,DAI Min,CAO Kai.Analysis of posterior debridement with osteotomy and titanium mesh bone graft fusion in the treatment of thoracolumbar tuberculosis[J].Chinese Journal of Clinical Medicine,2022,29(6):976-981 |
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| Author Name | Affiliation | E-mail | | DUAN Ping-guo | Department of Spinal Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China | | | LIN Si-jian | Department of Rehabilitation, the Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China | | | FAN Rong-hao | Department of Spinal Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China | | | GUO Run-sheng | Department of Spinal Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China | | | MA Sheng-biao | Department of Spinal Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China | | | DUAN Man-sheng | Department of Spinal Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China | | | YAO Hao-qun | Department of Spinal Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China | | | ZHANG Bin | Department of Spinal Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China | | | DAI Min | Department of Spinal Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China | | | CAO Kai | Department of Spinal Surgery, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China | kaichaw@126.com |
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| Abstract:Objective To explore the efficacy and safety of posterior debridement with osteotomy and titanium mesh bone graft fusion in the treatment of thoracolumbar tuberculosis. Methods From March 2014 to November 2018, 96 patients with thoracolumbar tuberculosis in the First Affiliated Hospital of Nanchang University were retrospectively analyzed. Among 96 patients, 29 patients accepting posterior debridement with osteotomy and titanium mesh bone graft fusion were allocated into group osteotomy (group O), and 67 patients accepting traditional posterior curettage debridement and bone graft fusion were allocated into group curettage (group C). Operation time, intraoperative blood loss, hospitalization time, postoperative complications were recorded. The visual analogue scale (VAS), Japanese Orthopaedic Association (JOA) scale and Oswestry disability index (ODI) were recorded. The local spinal interbody kyphosis angle (Cobb angle) and spinal bone fusion time were evaluated by the radiological imaging indexes. Results Compared with group C, the operative time was shorter in group O ([186.0±39.6] min vs [207.6±75.8] min, P＝0.043), and blood loss was less in group O ([903.0±88.9] mL vs [1 094.1±265.1] mL, P＝0.028). No significant difference was found in hospitalization time ([9.7±1.3]d vs [10.0±1.1] d) and correction degree of Cobb angle ([13.1±5.6] ° vs [12.6±4.9] °) between the two groups. Time of interbody fusion was shorter in group O than group C ([7.7±1.3] month vs [8.4±1.8] month, P＝0.047). No significant difference in VAS, JOA and ODI scores was found between the two groups. There were 2 and 11 patients with postoperative complications in group O and group C, respectively. No tuberculosis recurrence was found in group O, but there were 5 patients suffered from the spinal tuberculosis recurrence in group C. Conclusions Compared to the traditional curettage debridement, the debridement with osteotomy and titanium mesh bone graft fusion is a more effective and safe surgical strategy for treating the patients with thoracolumbar tuberculosis. |
| keywords:thoracolumbar tuberculosis osteotomy debridement spinal fusion |
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