To investigate the long-term clinical effect of long segment cortical bone track screw fixation for thoracolumbar tuberculosis.

The data of 76 patients with thoracolumbar tuberculosis who received posterior vertebral body fixation combined with anterior debridement and bone grafting from June 2015 to June 2019 were retrospectively collected. They were divided into CBT group and PS group according to different surgical methods (42 cases in CBT group and 34 cases in PS group). The intraoperative bleeding volume, operation time, visual analogue score (VAS) of incision pain and leg pain, bone graft fusion and complications, preoperative and postoperative Cobb angle in sagittal position, and postoperative JOA score of the two groups were observed and compared.

All 76 patients were followed up for (31.8±7.8) months in CBT group and (30.5±7.3) months in PS group. In CBT group, there were 23 males and 19 females, with an average age of (39.8±12.2) years; There were 19 males and 15 females in PS group, with an average age of (43.5±11.3). The bleeding volume (172.0±70.7 ml), fixed segment (243.0±75.4 ml) and hospital stay (8.9±2.9 days) in CBT group were significantly lower than those in PS group (11.4±1.7 days) (all P<0.05). The VAS score of low back pain in the two groups was significantly better than that before operation and at the 3rd, 7th, 3rd and last follow-up. The JOA scores of the two groups were significantly better than those before operation and 1, 3, 6 months after operation and at the last follow-up. The sagittal Cobb angle in the CBT group was better than that in the PS group at postoperative and final follow-up (postoperative: F=3.541, P=0.041; final follow-up: F=2.341, P=0.046).

Both groups have achieved the effect of correcting kyphosis deformity and significantly improve the quality of life of patients after operation. CBT screw has the advantage of preserving the motor unit of the spine.