Treatment of multiple spinal tuberculosis operative approach

【Objective】 To explore the surgical procedure for multi-segmental spinal tuberculosis.【Methods】 From November 2005 to June 2008,17 cases of multi-segmental spinal tuberculosis were treated with surgical operations.There were 10 males and 7 females with the age of 15~65 years old,the average age was 35.8 years old,the lesion located at thoracic vertebrae in 8 patients,at lumbar vertebrae in 3 patients,at thoracic-lumbar vertebrae in 6 patients,and 8 patients with spinal compression include 3 cases in Frankel grade D,1 cases in grade A,4 cases in grade C.All the patients were photographed with X ray,CT and MRI.Surgical procedure were performed according to the preoperative imaging signs.One group of patients with Lesion in anterior column vertebrae was treated by focus debridement and auto grafting operations.The second group of patients with Lesion in anterior and middle column vertebrae were treated by focus debridement and autoallergic rib grafting or titanium mesh support grafting and internal fixation operations,The third group of patients with lesion in anterior and middle column vertebrae accompaniment spinal compression were treated by debridement and orthopaedic and spinal decompression and internal fixation.We analyzed the status of the grafting bone fused,the neural function resumed,the malformation rectified and the EAR.【Results】 17 patients were followed up for a average of 13.5 months.1 year after surgery,the neural function was resumed Frankel grade D in 1 patient,and the others were returned to normal neural function.The average kyphosis-angle rectified 72.5%,erythrocyte sedimentation reached to normal an average of 4.3 months and an average of 3.6 month TB on symptoms.【Conclusion】 Spinal tuberculosis segmental lesions characteristic of tuberculosis has obvious heterogeneity,according to the scope of disease damage and whether accompaniment spinal cord compression,such as whether there is an important characteristic kyphosis segmental lesions on the choice of different surgical procedure on one-stage lesions for processing,combined with standard anti-TB chemotherapy and adequate preoperative preparation,can get a good result.