Anterior focus debridement with graft bone fusion and internal fixation in the treatment of thoracolumbar vertebra tuberculosis in one-stage

Objective To evaluate the timing of operation,operative approach and clinical efficacy of anterior focus debridement with graft bone fusion and internal fixation in the treatment of thoracolumbar vertebra tuberculosis in one-stage.Methods 52 cases of thoracolumbar vertebra tuberculosis were treated with anterior focus debridement with graft bone fusion and internal fixation.All patients were followed-up for 12 ～- 24 months(mean18 months).Relief of pain,progress of the neurological function,kyphosis correction and spinal stability were evaluated.The operation time,method and clinical efficacy were analyzed retrospectively.Results All cases were healed without recurrence,in which 49 cases achieved standard fusion of grafted bone,3 cases experienced disappearance of pain and came back to daily life although the standard recovery was not achieved,and 1 case got post-operative infection,and recovered with timely treatment.In addition,15 cases had the symptoms due to preoperatively compressed spinal cord and nerve,in which 14 cases recovered in 3 months after operation.The preoperative Cobb angle was 0°～-60.2°(mean 30.4°)and the postoperative Cobb angle was -5°～-35.2°(mean 12.7°).The mean correction Cobb angle was 17.7°.The loss of correction Cobb angle was 0°～-11°in one year,(mean 2.4°).Conclusion The treatment of thoracolumbar vertebra tuberculosis by anterior focus debridement with graft bone fusion and internal fixation is effective because it can decrease the rate of recurrence,correct kyphosis deformity and stabilize the spinal junction in early stage.