Objective To investigate the therapeutic effect of three surgical methods in elderly patients with lumbar tuberculosis. Methods A total of 240 elderly patients with lumbar tuberculosis were randomly assigned to simple posterior⁃approach group, simple anterior⁃approach group, or anterior⁃ and posterior⁃approach combination group, with 80 cases in each group. Corresponding surgical therapy was given to patients in various groups. The trauma indices (operation duration, bleeding volume, postoperative length of hospital stay, bone graft fusion time, and the occurrence states of complications within 12 months after operation), preoperative and 3⁃, 6⁃, and 12⁃month postoperative Cobb angle, erythrocyte sedimentation rate (ESR), Visual Analogue Scale (VAS) score, and Oswestry disability index (ODI) score, as well as the corrective rate and loss angle of Cobb angle 12 months after operation were compared between patients of the three groups. Results The anterior⁃ and posterior⁃approach combination group exhibited longer operation duration, greater bleeding volume, longer postoperative length of hospital stay, a greater incidence rate of complications within 12 months after operation as compared with the simple posterior⁃approach group and the simple anterior⁃approach group, and the simple anterior⁃approach group yielded shorter bone graft fusion time as compared with the simple posterior⁃approach group and the anterior⁃ and posterior⁃approach combination group (P<0.05). The simple posterior⁃approach group interpreted a larger Cobb angle after 3, 6, and 12 months of operation as compared with the simple anterior⁃approach group and the anterior⁃ and posterior⁃approach combination group (P<0.05). At 12 months after operation, the corrective rate of the simple posterior⁃approach group was higher, and loss angle of Cobb angle of the simple posterior⁃approach group was smaller than those of the simple anterior⁃approach group and the anterior⁃ and posterior⁃approach combination group (P<0.05). There was no statistically significant difference in ESR and VAS score after 3, 6, and 12 months of operation between patients of the 3 groups (P>0.05). The ODI score 3, 6, and 12 months after operation in the simple posterior⁃approach group was lower than that in the simple anterior⁃approach group and the anterior⁃ and posterior⁃approach combination group (P<0.05). Conclusion Anterior⁃approach surgery, posterior⁃approach surgery, and anterior⁃ and posterior⁃approach combination surgery can all effectively relieve pain in elderly patients with lumbar tuberculosis, decrease ESR, whereas posterior⁃approach surgery exerts superior effect of vertebral deformity correction, and better recovery effect of vertebral function, while anterior⁃approach surgery exerts shorter bone graft fusion time.

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