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| Clinical Study on CT-Guided Posterior Lesion Debridement and Bone Graft Fusion with Internal Fixation Combined with Thoracolumbar Decompression in the Treatment of Spinal Tuberculosis |
| XIE Liang, GE Yulong, ZHANG Yanxiang, et al |
| Baoji People's Hospital, Shaanxi Baoji 721000, China |
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Abstract Objective: To investigate the clinical efficacy of CT-guided posterior debridement, bone graft fusion, internal fixation combined with thoracolumbar decompression in the treatment of spinal tuberculosis. Methods: A total of 120 patients with spinal tuberculosis admitted to the hospital between June 2020 and June 2023 were selected for retrospective analysis and divided into anterior decompression group (anterior lesion debridement and bone graft fusion with internal fixation combined with thoracolumbar decompression surgery) and posterior decompression group (posterior lesion debridement and bone graft fusion with internal fixation combined with thoracolumbar decompression surgery) according to different surgical procedures. The propensity matching method was used to exclude confounding factors such as age and disease course. Finally, 58 cases in anterior decompression group and 62 cases in posterior decompression group were obtained. The perioperative indicators [surgical time, intraoperative blood loss, postoperative drainage volume], kyphosis Cobb angle immediately after surgery and at 6 months after surgery, spinal function [Kirkaldy-Willis functional classification] and spinal cord injury [American Spinal Injury Association Spinal Cord Injury (ASIA)] before surgery and at 6 months after surgery and incidence rates of surgical complications [dural tear, nerve injury, chronic back pain] within 6 months after surgery were compared between the two groups of patient. Results: The surgical time, intraoperative blood loss and postoperative drainage volume in posterior decompression group were significantly shorter or less than those in anterior decompression group (P<0.05). There was no significant difference in inter-group effect and interaction between groups before operation, immediately after operation and 6 months after operation (P>0.05), and the time effect was statistically significant (P<0.05). The Cobb angle of kyphosis in the two groups immediately after operation and 6 months after operation was less than that before operation (P<0.05), and there was no difference between the two groups (P>0.05). At 6 months after surgery, the Kirkaldy-Willis function score was significantly higher in both groups than that before surgery (P<0.05) while the ASIA rating was significantly lower than that before surgery (P<0.05), but there were no obvious differences between groups (P>0.05). The incidence rates of complications such as dural tear, nerve injury and chronic back pain were slightly lower in posterior decompression group compared with those in anterior decompression group within 6 months after surgery (P>0.05). Conclusion: CT-guided posterior lesion debridement and bone graft fusion with internal fixation combined with thoracolumbar decompression can significantly reduce the surgical time and blood loss, and promote the recovery of spinal structure and function in the treatment of spinal tuberculosis.
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2025, Vol. 31 
