Operative treatment thoracolumbar tuberculosis by one-stage debridement bone graft and internal fixation

Objective To evaluate the clinical effect of the one-stage debridement,bone graft and internal fixation for the operative treatment of thoracolumbar spinal tuberculosis. Methods Ninty-one thoracolumbar spinal tuberculosis cases from 1998 to 2006 were operated by one-stage debridement,bone graft and internal fixation. The location of lesions were T4-T10 in 32 cases,T11-L1 in 28 cases,L2-L4 in 26 cases,L5 in 5 cases. In all patients,40 cases were involved in single vertebra,36 cases were involved in 2 vertebrae,15 cases were involved in 3 vertebrae or the type of jumping style. There were 32 cases treated with Kaneda,26 cases with the Z-plate Ⅱ,28 cases with CDH M8 system and 5 cases with All Fix system. Anti-tuberculosis chemotherapy was regularly given for over 1 year after surgery. Results 86 cases were followed up 6 months to 8 years with an average 3.6 years. All the incisions acquired primary healing. The systematic and local symptoms were released postoperatively. Neurological function recovered in different degrees. All the infective focus had healed,the bone graft had fused and internal fixation had firmed. The average correction of kyphosis angle were 15°. Conclusion The curative effect of the one-stage debridement. bone graft and internal fixation with anti-tuberculosis chemotherapy regularly for the treatment of thoracolumbar spinal tuberculosis is satisfactory and reliable.