Clinical effect of anterior debridement with autograft bone fusion and internal fixation in the treatment of 43 cases of lumbar spine tuberculosis

Objective To evaluate the clinical effect of anterior debridement with autograft bone fusion and internal fixation in the treatment of lumbar spinal tuberculosis. Methods Forty-three patients of lumbar spinal tuberculosis admitted in our hospital from Jan. 2008 to Dec. 2010 were treated with anterior debridement with autograft bone fusion and internal fixation. The patients received conventional antituberculous therapy before and after operation, which were reviewed periodically and followed up for one year. Results (1) The short-term therapeutic effects: all the patients underwent operation successfully, with no occurrence of spinal cord injury, bone graft transposition or shedding. The Cobb angles of different segments were significantly recovered after treatment, compared with that before treatment (P0.05). Wounds healed up, and stitches were took out of the wound at 12.23 day in average. No obvious complications were found. The symptoms and signs of patients were improved at the time of discharge, with the discharge time of 16～23 days, 21.13 days in average. (2) The long-term therapeutic effect: 40 patients (93.02%) were followed up successfully, with no case of recurrence. The cure rate of lesions was 92.50%, and the success rate of bone grafting fusion was 87.50%. The Cobb angle of different segments showed no statistically significant difference one year after treatment (P0.05), and ASIA grading was significantly improved compared with before treatment. Conclusion Anterior debridement with autograft bone fusion and internal fixation is effective for treating lumbar spinal tuberculosis, which can obviously improve the kyphosis, with high rate of bone graft fusion.