Application of Cortical Bone Trajectory Screws in Elderly Patients with Lumbar Spinal Tuberculosis

To investigate the clinical efficacy of cortical bone trajectory (CBT) screws in the treatment of elderly patients with lumbar spinal tuberculosis.

A total of 45 elderly patients with lumbar spinal tuberculosis were allocated to 1 groups based on different surgical methods: 22 patients in group A received posterior CBT screw fixation combined with anterior debridement with a small incision and bone grafting, and 23 patients in group B underwent posterior pedicle screw fixation combined with anterior debridement with a small incision and bone grafting. The intraoperative blood loss, postoperative drainage volumes, Cobb angles, visual analogue scale scores, erythrocyte sedimentation rates (ESRs), and Frankel grades before and after surgery were analyzed. The surgical complications and spinal fusion were also assessed.

After a 3-month follow-up, 2 patients in group A and 3 patients in group B experienced anterior psoas muscle abscesses, which were cured by a second surgery. The remaining patients were healed by the first surgery. Spinal fusion after bone graft required 3 to 8 months (average, 4.9 months). There were no significant differences in surgery time, blood loss, drainage volume, and hospital stay between the 2 groups. The visual analogue scale scores, Cobb angles, ESRs, and Frankel grades were significantly improved after surgery in both groups.

The CBT screws were not inferior to traditional pedicle screws. The application of CBT- screws fixation combined with anterior debridement with a small incision and bone grafting was an effective and safe method to treat elderly patients with lumbar spinal tuberculosis.