Application of screw-rod system in anterior approach for thoracic spinal tuberculosis.

[Objective]To evaluate the effectiveness of the operation of anterior internal fixation by screw-rod system for treatment of thoracic spinal tuberculosis. [Methods]Forty-five patients with thoracic spinal tuberculosis were treated with 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 angles of the thoracolumbar spine were ranged from 15° to 36°(average of 24.5°).All patients received antitubercolosis chemotherapy for 4 to 6 weeks before operation.Forty-five patients were constructed with rib graft and anterior internal fixation by screw-rod system.Antituberculosis chemotherapy was regularly given for 1.5~2.0 years after surgery.[Results]All patients were followed-up for 18~36 months(average 28 months).Among 45 cases,28 were completely recovered(cure rate 62.22%),13 were partly recovered(cure rate 28.89%),total recovery rate were 91.22%.All patients showed successful autograft bone graft fusion.At 12 months after operation,the group had 1 cases of B,3 cases of D and 8 cases of E according to Frankel Standard.Cobb's angles of the thoracolumbar spine were ranged from 0° to 12°(average of 5.9°),showing statistically significant difference(P0.05) when compared with preoperation.The average immediate postoperative correction of kyphosis angle were 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,strengthen the spinal structure to prevent secondary paraplegia.