Three different bony graft methods in thoracic and lumbar spinal tuberculosis surgery

English Keywords:Tuberculosis  Spinal  Spinal fusion  Bone graft

English Abstract:

  【Abstract】 Objective: To evaluate the clinical outcomes of structure bone graft, micromorselized bone graft and titanium mesh bone graft for thoracic and lumber tuberculosis. Methods: 93 patients with lumbar and thoracic tuberculosis were divided in three groups, three different bone graft methods were used in three groups respectively after debridement(group A: structure bone graft, n=32; group B: micromorselized bone graft, n=35; group C: ttitanium mesh bone graft, n=26). The operation time, blood loss, correction and loss of correction of kyphosis, the fusion time were evaluated and compared among three groups. Results: All patients were followed up for 12-36 months. The operation time in group A, B and C was 23.4±4.3min, 5.2±2.4min, 25.6±3.6min respectively, with group B less than the other two groups(P<0.05), but no significant difference existed between group A and C(P＞0.05). The blood loss in group A, B and C was 553±53ml, 352±48ml, and 564±47ml respectively, with group B less than the other two groups(P<0.05), but no significant difference existed between group A and C(P＞0.05). The Cobb angle of kyphosis in group A, B and C before operation was 36.5°±5.9°, 36.2°±4.7° and 36.8°±5.1° respectively, no significant difference existed in three groups(P＞0.05). The Cobb angle of kyphosis in three groups after operation was 15.3°±3.6°, 15.6°±3.1° and 15.1°±2.9 respectively, no significant difference existed in three groups(P＞0.05). The Cobb angle of kyphosis at final follow-up for group A, B and C was 16.9°±3.6° with the loss of correction of 1.6°, 17.5°±3.1° with the loss of 1.9°, 16.8°±2.9° with the loss of 1.7°, which showed no significant difference in three groups(P＞0.05). The fusion time in group A, B, and C was 5.9±0.4 months, 4.1±0.3 months and 6.2±0.5 months respectively, with group B less than the other two groups(P<0.05), but no significant difference existed between group A and C(P＞0.05). Conclusions: The micromorselized bone graft is reliable for thoracic and lumbar tuberculosis.