Treatment Of Thoracolumbar Spinal Tuberculosis By One Stage Posterior Approach Internal Fixation And Anterior Focus Clearance With Bone Fusion

[Objective] To analyze the clinical effect of treatment of thoracolumbar spinal tuberculosis by one stage posterior approach internal fixation and anterior focus clearance with bone fusion, and seek for a treatment method of effective, safety and normative.[Method] Fifty-six patients(33 males and 23 females with the age of 21 to 67 years old, the average age was 39 years old)with thoracolumbar spinal tuberculosis were treated by one stage posterior approach internal fixation,anterior focus clearance and bone fusion from March 2006 to March 2009. There were 18 patients focus on T11-L1, 38 patients focus on L2-L5. The pathologic diagnosis were spinal tuberculosis and all the patients have had the regular anti-tuberculosis treatment in the preoperative and postoperative.[Result] T-test was used to analysis the data by SPSS13.0. All patients were diagnosed spinal tuberculosis and followed up for 11-30 months with an average of 18 months. There were no severe symptoms such as increased paraplegia and respiratory dysfunction in the postoperative, and the severe side effects did not occurred during the anti-tuberculosis treatment. At the same time all patients have had varying degrees of thoracic and lumbar back pain relief. There were 1 case of grade B recovered to D-level , 3 cases of C-level recovered to 2 cases of grade D, 1 case of grade E, 14 cases of the class D returned to the class D in the 18 cases of neurological disorders by the Frankel classification. The X-ray inspection showed good fusion, and the erythrocyte sedimentation rate check were normal range half a year after surgery. The average Cobb angle of kyphosis was 22.2°before surgery,but it was 5.3°after 1 week of surgery and followed up was 6.3°of 1 year later. There were significantly different with the Cobb angle of kyphosis between preoperative and postoperative, and no significantly different between postoperative and followed up of one year later (P<0.05).[Conclusion] One stage posterior approach internal fixation and anterior focus clearance with bone fusion is a much better surgical for the treatment of thoracolumbar spinal tuberculosis. It can be do that the local clear focus of spinal tuberculosis, thorough and effective spinal cord decompression, reconstruction by bone fusion and t he stability of a strong three-column after the kyphosis correction.