Clinical observation of one nail-stick system internal fixation for long-segment adjacent multivertebral tuberculosis

[Objective]To evaluate the method and clinical effect of anterior focus clearance with autograft bone fusion and internal fixation in treating long-segment adjacent multivertebral tuberculosis. [Methods]During March 2007 to September 2009,9 patients underwent anterior focus clearance with autograft bone fusion and internal fixation via thorax in treating thoracic vertebra tuberculosis.Six were male and 2 were female.The average age was 32 years old(range,20 to 42).The highest segmen was the fifth thoracic vertebra and the lowset was the second lumbar vertebra.Twenty-nine patants had thoracic vertebra disease and 11 cases had lumbar vertebra.Five had 5 vertebra lesions.All patients had different kyphosis,and the average kyphosis angle was 24.30.All patients received antituberculous therapy 4-6 weeks before operation. [Results]All patients were followed up for 16～48 months,8 were recovered after first operation,one had recurrenu.The average Cobb angle of postoperation kyphosis was 7.5°±4.2°.The loss of correction Cobb angle was 3.2°± 1.6° at last follow up.The bone fusion started months after operation on CT scans.Six patunts with titanium had different recovery after 12 months postoperatirely. [Conclusion]Long-segment adjacent multivertebral tuberculosis had a broad lesion and unstable multivertebrae.The treatment of adjacent multivertebral tuberculosis by anterior focus clearance,intervertebral autograft and internal fixation in one stage is effective.Our current study indicates that anterior bone fusion and internal fixation in one-stage can correct kyphosis effectively and rebuild spinal stability.It is a good choice for surgical treatment for long-segment adjacent multivertebral tuberculosis.