One stage anterior debridement and instrumentation in treatment of thoracic spinal tuberculosis

Objective To evaluate efficacy of one stage anterior debridement,strut graft and instrumentation in treatment of thoracic spinal tuberculosis.Methods 21 patients with thoracic spinal tuberculosis,including 14 males and 7 females,were treated with debridement and strut graft with iliac bone combined with instrumentations.The locations of lesions located at the level of T5-12.Kyphosis deformity presented in all the patients with an average Cobb angle of 31.7°(range form 27°to 57°).The neurological symptoms were developed in 15 patients,encompassing 2 cases of grade B,6 cases of grade C and 7 cases of grade D(rated by Frankel grading).Anti-tuberculosis chemotherapy was continued for at least 12 months postoperatively.Results Debridement,strut graft and fixation were successfully completed in all the 21 patients.Incisions were healed at one stage.Except for 3 cases of postoperative pleural effusion and atelectasis,no serious complications occurred.15 patients with preoperative neurologic deficit had their Frankel grading improved for an average of 1.33 grades.Correction of kyphosis by an average of 19.4 °was achieved,without loss of correction during the follow-up period.Bone healing was obtained in all the patients in average of 6.8 months after surgery.Conclusions one stage anterior debridement,strut graft and internal fixation is a safe and effective procedure in treatment of thoracic spinal tuberculosis,which can effectively remove the focus,reconstruct and maintain the spinal stability and creates a suitable condition for the recovery of neurological functions.