Treatment of spinal tuberculosis with neural symptom patients by one stage radical debridement with bone graft and selective internal fixation

Objective To investigate the efficiency of surgical management of spinal tuberculosis with neural symptom by one stage radical debridement with bone graft and selective internal fixation.Methods 18 patients of spinal tuberculosis were treated with one stage radical debridement with bone graft and selective internal fixation with anterior or posterior or renal incision ect.All patients underwent at least three weeks of anti tuberculosis treatment before operation.Simultaneous bone grafting,and continued postoperative antituberculous therapy were done for one year.Results Nerve damage of 18 cases patients had different degree of recovery postoperatively.1 case of thoracolumbar spinal tuberculosis(T12～L1) with delayed healing of the incision was cured after debridement and adjustment of anti-tuberculosis drugs combined with changing dressing.All patients with bone grafting were fused.X-ray film showed no sign of spinal destabilization and breakage of internal fixation.No tuberculosis recurrence and spinal deformity was found during the followup period.Conclusions Radical debridement with bone(or combined with metal cage) graft and selective internal fixation in the first stage is safe and effective for spinal tuberculosis with neurological symptoms on the basis of effective antiTB drugs.