| Objective: To analyze the clinical effect of single-stage anterior debridement with allograft bone fusion and instrumentation in treating thoracic and lumbar tuberculosis Methods: Fourty-one patients (15 male and 26 female; average age, 36years) thoracic and lumbar tuberculosis were treated by single-stage anterior debridment, allograft bone fudion and internal fixation from June 2007 to March 2009. Union march letter?telephone cum hospital out-patient clinic followed up. Process involv perhaps bis and bis-above vertebral body. T4 and L4 spinal segments were affected. Neurological deficits were found in 22 patients. Before surgery, patients received standard anti-tuberculosis chemotherapy for 2 to 4 weeks. The tuberculous lesion region was completely resected, Allograft bone was hsrvested to complete interbody fusion, and an anterior instrumentation was used to reconstruct the stability of the affected segments. Anti-tuberculosis chemotherapy was continued for 12~18 months after surgery. Result: All pratients were followed up with the average of 21 months. All cases were healed without chronic sinus formation or any recurrence of tuberculosis during the follow-up period. A solid fusion was achieved in all cases. 7 patients with preoperative kyphosis, the deformity was corrected from an 42°average of to an average of 16°after surgery. No significant loss of deformity correction was noted in these patients. ESR of these patients reduced a month after operation and reached to normal level 6 months later. Of all patients with neurological deficits, 22 patients showed obvious improvement; while one patient with Frankel D lesion remained unchanged. Conclusion: For patients with thoracic an lumbar tuberculosis, single-stage anterior debridement with allograft bone fusion and instrumentation were found to be effective in reconstructing spinal stability arresting the disease, correcting kyphotic deformity and maintaining correction until solid spinal fusion. |
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