One-stage anterior debridement,allografts and internal fixation by screw-rod system for thoracic spinaltuberculosis

Objective:To evaluate the effectiveness of the operation of anterior internal fixation by one screw-rod system and rib graft for treatment of thoracic spinal tuberculosis.Methods:45 patients with thoracic spinal tuberculosis were treated by the operation of one-stage anterior debridement, spinal cord decompression,rib graft and internal fixation by screw-rod system,from Jan 2003 to Apr 2008.There were 31 males and 14 females with the mean age of 41.3 years(30 to 67 years old). According to Frankel Standard,the group had 5 cases of C and 7 cases of D.Cobb's angles of the thoracolumbar spine ranged from 15° to 36°(average of 24.5°).All patients received antituberculosis chemotherapy for 4 to 6 weeks before operation.45 patients were constructed with rib graft and anterior internal fixation by screw-rod system.Antituberculosis chemotherapy was given for 1.5～2.0 years after surgery.Result:All patients were followed-up for 18～36 months(average 28 months).Among 45 patients,28 completely recovered(cure rate 62.22%);13 partly recovered(cure rate 28.89%),total recovery rate being 91.22%.All patients showed successful autograft bone graft fusion.At 12 months after operation,the group had 1 case of B,3 cases of D and 8 cases of E according to Frankel Standard.Cobb's angles of the thoracolumbar spine ranged from 0° to 12°(average of 5.9°),showing statistically significant difference(P0.05) when compared with that before operation.The average immediate postoperative correction of kyphosis angle was 18.6°;the average correction of kyphosis angle at the time of last follow-up was 16.7°;the average loss of correction was only 1.9°.Conclusion:Operation of anterior internal fixation by screw-rod system and rib graft for treatment of thoracic spinal tuberculosis can cure tuberculosis without recurrence and can also correct deformity and strengthen the spinal structure to prevent secondary paraplegia.