Comparative analysis of the efficacy of a transverse process bone graft with other bone grafts in the treatment of single-segment thoracic spinal tuberculosis

BACKGROUND: There was a controversy about bone grafting of spinal tuberculosis treatment. The aim of this study was to compare the clinical efficacy of a new bone grafting method—transverse bone grafting (TBG)—with iliac bone grafting (IBG) and titanium mesh grafting (TMG) in the treatment of single-segment thoracic spinal tuberculosis. MATERIAL AND METHODS: TBG was undertaken in 30 patients (group A), IBG was carried out in 28 patients (group B), and TMG was performed in 36 patients (group C). The operative time, intraoperative blood loss, postoperative drainage amount, postoperative complications, length of hospital stay, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, visual analog scale (VAS) score for back pain, Oswestry dysfunction index (ODI), intervertebral height, and time to bone graft fusion were compared. Changes in the Cobb angle of kyphosis, intervertebral height, and loss to the final follow-up were measured. Neurological function recovery was evaluated according to the criteria of the American Spinal Injury Association (ASIA). RESULTS: The operative times in group A was significantly shorter than those in groups B and C (P(AB) = 0.036, P(AC) = 0.005, P(BC) = 0.901). The hospital stay in group A was significantly shorter than that in groups B and C (P(AB) = 0.022, P(AC) = 0.031, P(BC) = 0.424). The intraoperative blood loss in group A was significantly less than that in groups B and C (P(AB) = 0.045, P(AC) = 0.004, P(BC) = 0.586). The VAS score, ODI, ESR level, CRP level, Cobb angle of kyphosis, and intervertebral height of the affected segment were significantly improved compared with those before surgery (P < 0.05). CONCLUSION: For the treatment of single-segment thoracic spinal tuberculosis, the new interbody fusion technique using transverse process bone grafting is a safe, reliable, effective, and ideal bone grafting method.