Complete debridement and bone graft with anterior instrumentation for spinal tuberculosis.

Objective To evaluate the clinical efficacy of complete debridement and bone graft with anterior instrumentation for spinal tuberculosis.Methods Eighty eight patients with spinal tuberculosis were treated with complete debridement and bone graft with anterior instrumentation for tuberculosis from Jan 1998 to Dec 2003.There were 50 males and 38 females and mean age was 43.6 years old(16 to 58 years old).All these tuberclosis patients had different symptoms and accompanied with local pain and spinal kyphosis deformity with Cobb's angles of the thoracolumbar spine were ranged from 17°to 50°(average of 35°).Their ESR ranged from 35 to 136 mm/h.All patients received anti-tubercolosis chemotherapy for 2 to 4 weeks before operation.88 patients were reconstructed with iliac grafting and Z-plate fixation.Anti-tuberculosis chemotherapy regularly was given for 9 months after surgery.Results All patients were followed-up for 1.5￣5 years(average 2.8 years).Their lesions were eliminated completely.The wound healed after surgery.The graft fused 6￣8 months after surgery and 25 paraplegia patients recovered completely 6 months post-operation and kyphosis was corrected partly.The ESR of these patients decreased to a normal level 2 to 3 months after surgery.Conclusions Anterior complete debridement and reconstruction with iliac grafting and internal fixation can cure tuberculosis without recurrence and can also correct deformity,strengthen the spinal structure to prevent secondary paraplegia.