[Treatment of C7 severe fracture and dislocation combined with cervical spinal cord injury by one stage reduction and internal fixation with anterior posterior approaches : a case report].

OBJECTIVE To evaluate the clinical outcomes of one-stage transpedicular debridement, posterior internal fixation, RBK mixed streptomycin filled bone grafting for the treatment of elderly patients with thoracolumbar tuberculosis. METHODS The clinical data of 20 elderly patients with thoracolumbar tuberculosis underwent one stage transpedicular debridement, posterior internal fixation, OSTEOSET RBK mixed streptomycin-filled bone grafting from September 2006 to July 2017 were retrospectively analyzed. There were 12 males and 8 females, aged from 62 to 83 years with an average of (72.4±6.9) years old. Visual analogue scale (VAS), Oswestry Disability Index (ODI)were used to evaluate the pain and spinal function. The kyphosis angle (Cobb angle) of the lesion segment and the bone growth of the lesion area were observed by the X-ray films. RESULTS All the operations were successful, the operation time was (160.9±23.8) min, and the intraoperative blood loss was (317.9± 112.7) ml. The incisions were healed by first intention, and no sinus and incision were delayed. Spinal tuberculosis was completely cured, Frankel grade has one or more improvements. The VAS score decreased from (7.50±1.15) points before surgery to (1.70±1.39) points at 12 months after surgery (P<0.05). The ODI score decreased from preoperative (92.50±1.17)% to (12.80±0.89)% at the final follow up (P<0.05). The sagittal Cobb angle of the lesion segment decreased from preoperative (24.2±1.6)° to (8.3±0.7)°at 12 months after surgery(P<0.05), the kyphosis deformity was significantly corrected. In all cases, bone fusion was achieved in bone graft area, without bone nonunion and device fracture complications. CONCLUSION One-stage transpedicular debridement, posterior internal fixation, RBK mixed streptomycin filled bone grafting is suitable for thoracolumbar tuberculosis patients with good general condition and less vertebral destruction.