关键词: 斜外侧入路；经皮椎弓根螺钉；腰椎结核；病灶清除；植骨融合

Abstract: Objective To assess the efficacy of the oblique lateral approach with percutaneous pedicle screw fixation for treating lumbar spinal tuberculosis and compare it with conventional posterior surgery.Methods A retrospective study analyzed 29 patients treated for lumbar spinal tuberculosis in our hospital from January 2020 to October 2022.They were divided into two groups according to different treatment methods,the observational group (18 case) underwent oblique lateral lesion clearance,bone graft fusion,and posterior percutaneous pedicle screw fixation,while the control group (11 case) received conventional posterior lesion clearance,bone graft fusion,and internal fixation surgery.The operative time and intraoperative blood loss were compared between the two groups.Operation time and intraoperative blood loss were compared between the two groups,the healing of tuberculosis foci, ASIA grade, intervertebral bone graft fusion, VAS score, ODI score, Cobb Angle and complications were recorded in the two groups,follow-up was 12 months.Results There was no statistically significant difference in operation time and intraoperative blood loss between the two groups (P>0.05). All patients' tuberculosis foci healed, and the neurological function ASIA classification was E level, with an intervertebral bone graft fusion rate of 100%. The VAS scores of the observation group and the control group at 3 days, 3 months, and 12 months after surgery were (3.79 ± 0.57) ° vs (4.27±0.61) °, (0.95±0.43) ° vs (1.44±0.42) °, (0.53±0.20) ° vs (0.76±0.19) °, respectively, and the difference between the two groups was statistically significant (P<0.05). The ODI scores of the observation group and the control group at 3 days, 3 months, and 12 months after surgery were (29.94±2.84) ° vs (31.36±2.58) °, (8.94±1.98) ° vs (11.27±2.19) °, (9.28±2.52) ° vs (12.72±1.90) °, respectively, and the difference between the two groups was statistically significant (P<0.05). The Cobb angles of the observation group and the control group at 3 days, 3 months, and 12 months after surgery were (41.82±2.35) ° vs (41.5±2.72) °, (41.28±1.67) ° vs (41.18±1.60) °, (39.33 ±3.52) ° vs (38.46±2.75) °, respectively, and the difference between the two groups was not statistically significant(P＞0.05）.Conclusion Both surgical techniques can promote the healing of tuberculosis lesions and bone graft fusion. The oblique lateral approach combined with percutaneous pedicle screw fixation has the advantages of minimal invasiveness and better functional recovery.

Key words: oblique lateral approach;percutaneous pedicle screw fixation;lumbar spinal tuberculosis;lesion clearance;bone graft fusion