Single-stage debridement combined with bone grafting and internal fixation in treatment of tuberculosis of thoracolumbar spines through Wiltse approach

Objective To investigate the clinical outcomes of single-stage debridement combined with bone grafting and internal fixation in treatment of tuberculosis of thoracolumbar spines through Wiltse approach. Methods 32 patients with thoracolumbar spines were treated with single-stage debridement combined with bone grafting and internal fixation in this study. The recovery of these patients' tubercular outcome,kyphotic malformation,bone graft fusion and neurological function were recorded. Results One case of rupture of pleura was self-healing through placing closed thoracic drainage tube for 2 days. One case of leakage of cerebrospinal fluid was self-healing through unplugging drainage tube and pressuring dressing on the wound for one week. All incisions achieved primary healing. The correction rate of Cobb angel for 27 cases with kyphosis was 88. 6% on average after operation. All cases were followed up for 16 ~ 38 months 24 cases with neurological dysfunction among the all patients were followed up in one year after operation,the recovery of neurological function to 21 cases was obvious,and there were no any improvements to the other 3 cases. All patients achieved bone healing and tubercular symptoms disappeared completely 14 months later following surgery. In the last follow-up,there were no any relapse of tuberculosis,internal fixation loosed or fractured. Conclusions It is safe and effective that single-stage debridement combined with bone grafting and internal fixation in treatment of tuberculosis of thoracolumbar spines through Wiltse approach.