Chinese Journal Of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (3): 333-337.doi: 10.13418/j.issn.1001-165x.2018.03.020

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Autogenous morselized bone garft versus autogenous iliac bone graft in the treatment of thoracic and lumbar spinal tuberculosis

LI Jian-xiao1, OU Yun-sheng1, GAO Yong-jian2, ZHAO Zeng-hui1, ZHU Yong1, DU Xing1, CHEN Yan-yang1   

  1. 1.Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China; 2.Department of Orthopedics, the Third Affiliated Hospital of Chongqing Medical University, Chongqing 401120, China
  • Received:2017-10-20 Online:2018-05-25 Published:2018-07-04

Abstract:

Objective Retrospectively evaluate the clinical outcomes of autogenous morselized bone graft and autogenous iliac bone graft for single-segment thoracic and lumbar spinal tuberculosis. Methods  Between August 2012 to June 2016,58 cases of thoracic or lumbar spinal tuberculosis were treated by the surgery of interbody bone graft after debridement and fusion combined with posterior instrumentation.31 patients in group A underwent autogenous morselized bone graft and 27 cases in Group B underwent autogenous iliac bone graft. The surgical duration, blood loss, visual analog scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-Reactive protein (CRP), The intervertebral height, segment-kyphotic angle were recorded and compared. The loss of segment kyphotic angle and intervertebral space height,and the bone fusion time on X-ray or CT scanning at the time point of post-operation and follow-ups were recorded and compared. Results Final follow-up time ranged from 15 to 38 months,with an average of 26 months. The operation time was 194.2±34.9 min in group A and 240.0±61.5 minutes in group B(P<0.05). The blood loss was 282.2±130.0 ml in group A and 540.7±276.6 ml in group B(P<0.05). The bone fusion time was 5.8±1.0 months in group A and 8.3±3.6 months in group B(P<0.05). Both groups got good kyphosis correction and intervertebral height restoration. The loss of kyphosis correction and intervertebral height in group A were found to be more than those in group B, but with no significant difference between group A and group B (P>0.05). Conclusions Based on this retrospective study, autogenous morselized bone graft has a shorter surgical duration, lower blood loss and shorter bone fusion time compared with the autogenous iliac bone graft. The autogenous morselized bone graft is a safe and effective approach in treating single-segment thoracic and lumbar tuberculosis.

Key words: Spinal tuberculosis,  Bone grafting autogenous iliac bone,  Autogenous micromorselized bone,  Posterior approach