Prevention and treatment of complications of one stage surgical treatment of thoracolumbar spinal tuberculosis by anterior debridement with autograft bone fusion and spinal reconstuction

Objective:To review and analyze the complications of thoracolumbar spinal tuberculosis by anterior debridement with autograft bone fusion and spinal reconstuction.Method:From February 2000 to December 2006,there were 79 patients with thoracic or lumbar tuberculosis were received anterior debridement with autograft bone fusion and spinal reconstruction in author′s clinic,which included 36 male and 43 female.The average age was 39.8 years(range,12 to 78 years).The lesion located at the T4~T10 level in 28 patients,T11~L1 in 32,L2~L4 in 19.The intraoperative and postoperative complications were analysed.Result:The average period of follow-up was 18.2 months(range,5 to 40 months).The complications could be divided into intraoperative complications and postoperative complications.Intraoperative complications included:chylous fistula(1 patient),intercostal nerve injury(4 patients).Postoperative complications included:deep venous thrombosis(1 patient),pulmonary atelectasis(2 patients),recurrence(2 patients),screw cut-out from vertebrae(2 patients).The complications were all connected to the carelessness or the improper indications.Conclusion:In order to reduce the incidence of complications in surgical treatment of thoracolumbar spinal tuberculosis by anterior debridement with autograft bone fusion and spinal reconstuction,the indication,the anatomy,the surgical skill,the radical debridement and the appropriate perioperative management are all essential.