Evaluation of clinical efficacy of autogenousmorselizedand impacted bone graft in treatment of lower lumbar tuberculosis

Objective To evaluatethe clinical efficacy of autogenousmorselizedand impacted bone graft in the treatment of lower lumbar tuberculosis. Methods Thirty-five patients with lower lumbar tuberculosis （L3-S1） were randomly divided into the observation （n = 18） and control groups （n = 17）. In the observation group,autogenousmorselizedand impacted bone graft combinedwith pedicle screw for intervertebral fusion was adopted. In the control group,interbody fusion cage was employed for intervertebral fusion. All patients were strictly required to wear the lumbar bracefor 3 months after surgery and receive standardized anti-tuberculosis treatment for 12 to 18 months. The clinical efficacy （Macnab method）, intervertebral disc space height and cobb angle by X-ray examination, pain alleviation （Oswestry Disability Index Questionnaire） and bone graft fusion of autogenousmorselizedand impacted bone were compared before treatment, 1 month after treatment and during follow-up. Results All patients successfully completed the surgery without surgical complications. The mean follow-up time was 14 months （9-20 months）. The clinical efficacy did not significantly differ between two groups （P > 0.05）. At 1 month after treatment and the final follow-up, the pain alleviation in the observation group was significantly higher than that in the control group （both P < 0.001）. At 1 month after treatment, the cobb angle in the observation group was remarkably better compared with that in the control group. At the final follow-up, intervertebral disc space height in the observation group was remarkably better compared with that in the control group （both P < 0.05）. Nevertheless, the intervertebral disc space height at postoperative 1 month did not significantly differ between two groups （P > 0.05）. Conclusion Autogenousmorselizedand impacted bone graft combined with pedicle screw fixation yields equivalent clinical efficacy with conventional intervertebral fusion cage, whereas has advantages in terms of the improvement of postoperative pain and intervertebral disc space height.