Clinical Analysis of 79 Cases of Surgical Management for Thoracolumbar Spinal Tuberculosis

Objective To explore the clinical efficacy of onestage debridement,bone graft fusion and internal fixation in thoracolumbar spinal tuberculosis.Methods Seventy-nine patients with thoracolumbar spinal tuberculosis were treated surgically by a single stage procedure in our department from Sep 2002 to Jul 2008,there are 1～2 vertebral body lesions involved in 72 cases,≥3 vertebrae in 7 cases,leap spinal tuberculosis in 4 cases.The surgical procedures included:a)anterior debridement,fusion with autograft and internal fixation.b)posterior pedicle fixation and anterior debridement,interbody fusion.All patients wore the brace for 3～6 months,12～18 months anti-TB drugs postoperatively.Regular outpatient follow-up,laboratory tests and imaging observations.Results All patients were followed up for 2～9 years,were clinically cured.Spinal solid fusion at the interface between graft and adjacent vertebral bodies was shown radiologically in mean 4.7 months.There was a kyphosis correction of 18.70° after operation.There was a 2° loss of kyphosis correction during follow-up period.Symptoms of 29 paraplegia cases were significantly improved.Conclusion One-stage debridement,bone graft fusion and internal fixation is an important treatment of spinal tuberculosis.Effective anti-TB chemotherapy is the basis for cure of spinal tuberculosis.