[One-stage posterior debridement, bone graft, and internal fixation for thoracic tuberculosis].

OBJECTIVE: To evaluate the clinical effectiveness and advantages of one-stage posterior debridement, bone graft, and internal fixation for thoracic tuberculosis. METHODS: The data were retrospectively analysed, from 21 cases of thoracic tuberculosis undergoing one-stage posterior debridement, bone graft, and internal fixation between June 2007 and November 2009. There were 16 males and 5 females with an average age of 42.2 years (range, 22-73 years). The average disease duration was 13.2 months (range, 7-21 months). The lesions were located at the level of T5,6 (1 case), T6,7 (1 case), T8,9 (4 cases), T9,10 (3 cases), T10,11 (5 cases), T11,12 (6 cases), and T9-11 (1 case). According to the Frankel grading criterion, the neurological function was rated as grade B in 2 cases, grade C in 6 cases, grade D in 10 cases, and grade E in 3 cases. The preoperative Cobb angle was (26.3 +/- 9.2) degrees. The erythrocyte sedimentation rate (ESR) was (35.9 +/- 11.2) mm/1 hour. RESULTS: Thoracic tuberculosis was confirmed in postoperative pathological examination in all 21 cases. All incisions healed primarily without fistulae formation. The average follow-up time for 21 patients was 16.2 months (range, 1-3 years). Bony fusion was achieved within 7-12 months (mean, 9 months) without pseudoarthrosis. No loosening and breakage of internal fixation were found, and no local recurrence occurred. The ESR decreased to (25.1 +/- 8.9) mm/1 hour at 1 week postoperatively, showing significant difference when compared with preoperative value (t = 5.935, P < 0.01); it decreased to (14.1 +/- 4.6) mm/1 hour at 3 months postoperatively. According to Frankel grade, the neurological function was significantly improved at 1 year after operation (chi2 = 13.689, P = 0.003). The average Cobb angle was (17.1 +/- 4.5) degrees at 1 years postoperatively, showing significant difference when compared with preoperative value (t = 7.476, P < 0.01). CONCLUSION: One-stage posterior debridement, bone graft, and internal fixation has a good clinical effectiveness for thoracic tuberculosis with less injury and complete focal cleaning, as well as a good effectiveness of spinal canal decompression and kyphosis deformity correction.