Anterior debridement and bone grafting with posterior instrument in surgical treatment of thoracolumbar spinal tuberculosis

Objective To evaluate the surgical methods of thoracolumbar spinal tuberculosis. Methods The surgical results of 42 patients treated by anterior debridement and bone grafting and additional posterior instrumentation were analyzed retrospectively. There were 24 males and 18 females with an average age of 38.2 years in this series. The lesions involved 11 cases in thoracic segments , 14 cases in thoracolumbar segments and 17 cases in lumbar. All these patients were treated with routine antituberculous medication for at least 3 weeks pre-operatively. Then they were underwent posterior transpedical interfixation and anterior radical focus resection plus bone grafting. The anterior approach included thoracotomy, thoracoabdominal incision, pararectal retroperitoneal and midline rectus split with retroperitoneal approach respectively. Average duration of surgery was 230 min, and the mean blood loss was 550ml. Anti-tuberculosis chemotherapy was used for 18 months. Results All patients were followed up with an average 24.3 months (range from 8 to 46 months). Bony fusion was obtained in all patients. The back pain and neurological deficits showed obvious improvement in most patients. There was no recurrence of the disease. Conclusions Anterior debridement and bone grafting with one-stage posterior instrument can achieve satisfactory results in the treatment of thoracolumbar spinal tuberculosis.