One-stage anterior radical debridement,titanium mesh bone fusion and internal fixation for the treatment of thoracolumbar spinal tuberculosis

[Objective]To evaluate the curative effect of the one-stage anterior radical debridement,titanium mesh cage bone fusion and inernal fixation for the treatment of thoracolumbar spinal tuberculosis.[Method]Twenty-two thoracolumbar spinal tuberculosis cases from January 2003 to February 2006 were analyzed retrospectively,among whom 12 were male and 10 were female,age ranging from 19 to 76 years with a mean of 36 years.T_9~L_5 vertebrae were involved in,in detail 1 was involved in single vertebra,17 were involved in 2 vertebrae,3 were involved in 3 vertebrae,1 was involved in the type of jumping style,M=2,Q=0.All cases received one-stage anerior radical debridement,titanium mesh cage bone fusion and internal fixation along with strict anti-tuberculosis chemical therapies.The improvement of symptoms and neurological function,angles reduced by the surgeries and bone fusion,angles lost as well as the subsidence of the titanium mesh during the long-term follow-up were observed and compared statistically.[Result]No recurrence was found in the follow-up period extending from 6 months to 24 months with an averaging of 12.5 months.All the incisions acquired primary healing.The systematic and local symptoms were released postoperatively.Neurological function recovered in different degrees(P0.01);The graft got fusion in 3 months to 6 months,averaging 4 months;the median(M)of the reduced kyphosis Cobb's angle was 20.4°(Q=15°,P= 0.0 001 ),losing 1.85°(Q=3.6°,P= 0.0 001 )in the follow-up.The medians of titanium mesh cage subsidence were 11.0% and 8.0% proximally and distally,the quartiles were 10.7% and 9.0%,both P 0.0 001 .Neither internal fixation loosening nor obvious titanium mesh cage shifting was found.[Conclusion]The curative effect of the one-stage anterior radical debridemem,titanium mesh cage bone fusion and internal fixation for the treatment of thoracic lumbar spinal tuberculosis is satisfactory and reliable.