前路病灶清除植骨融合内固定联合抗骨质疏松治疗老年脊柱结核

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Abstract Objective〓To evaluate the clinical efficacy of anterior debridement，bone graft fusion，and internal fixation combined with antiosteoporosis treatment in elderly patients with spinal tuberculosis and osteoporosis.Methods〓This study encompassed 98 elderly patients with spinal tuberculosis and osteoporosis who were treated from March 2021 to June 2022.Utilizing a random number table method，the patients were divided into two groups：The observation group，consisting of 48 patients (28 males and 20 females)，with an average age of (65.35±8.20)years，ranging from 60 to 73 years old，and the control group，comprising 50 patients (28 males and 22 females)，aged between 62 and 75 years，with a mean age of (67.20±7.60)years.Both groups underwent anterior debridement，bone graft fusion，and internal fixation，accompanied by antituberculosis treatment administered preand postoperatively for 12~18 months.The observation group additionally received antiosteoporosis treatment，encompassing calcium carbonate D3，alfacalcidol，and zoledronic acid injection，whereas the control group did not receive formal antiosteoporosis medication.Parameters such as surgical time，intraoperative blood loss，postoperative bed rest duration，erythrocyte sedimentation rate(ESR)，visual analogue scale(VAS) for pain assessment，kyphotic Cobb angle，bone graft fusion time，postoperative complications，and bone mineral density (BMD) at the final followup were recorded and statistically analyzed.Results〓 All patients were followed up for a duration ranging from 13 to 17 months，with an average followup period of (14.00±2.30)months.The observation group demonstrated notable benefits from the antiosteoporosis treatment.Specifically，the postoperative bed rest time in the observation group was (3.95±0.76) weeks，which was considerably shorter than the (4.58±1.01) weeks required by the control group (P＝0.027).At the sixmonth postsurgery mark，the ESR in the observation group measured at (27.60±3.40)mm/h，whereas the control group recorded an ESR of (30.20±2.97)mm/h (P＝0.008).Additionally，the VAS in the observation group stood at (2.20±0.83)，notably lower than the (3.40±0.77) score observed in the control group (P＝0.001).Furthermore，the bone graft fusion time in the observation group was (3.95±0.43)months，significantly shorter compared to the (4.57±0.79)months in the control group (P＝0.003).Regarding the correction degree of kyphotic Cobb angle，the observation group achieved (5.93±0.94)°，while the control group reached (6.73±1.80)°，although this difference was not statistically significant (P＝0.081).Upon the final followup，the Tscore for osteoporosis in the observation group was (－2.40±0.39)，which was significantly higher than the (－3.20±0.40) recorded in the control group (P＜0.001).Lastly，the incidence of postoperative complications in the observation group was 5.00%，which was lower than the 9.10% seen in the control group，albeit this difference was not statistically significant (P＝0.662).Conclusion〓Anterior debridement，bone graft fusion，and internal fixation combined with formal antiosteoporosis treatment show significant advantages in postoperative recovery，inflammatory markers，osteoporosis，pain relief，and bone graft fusion in elderly patients with spinal tuberculosis and osteoporosis.This approach provides valuable insights for related clinical practices.

Key words： spinal tuberculosis osteoporosis anterior lesion debridement clinical effect

Corresponding Authors: Wu Huarong

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	Li Jikai
	Wang Huiwang
	Li Tongxian
	Wu Huarong

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Li Jikai,Wang Huiwang,Li Tongxian, et al. Anterior Debridement，Bone Graft Fusion，and Internal Fixation Combined with Anti Osteoporosis Treatment in Elderly Patients with Spinal Tuberculosis[J]. sygkzz, 2024, 30(6): 481-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2024/V30/I6/481

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[1]	. [J]. sygkzz, 2024, 30(5): 468-.