| Objective: To evaluate the clinical efficacy of posterior radical focus debridement,bone graft and instrumentation surgical treatment of upper thoracic spinetuberculosis. Methods: Retrospective analysis from March2010to June2013,24patients suffering from upper thoracic spine TB(13males and11females, aged20-65years, mean age38.3years, the courses of disease were6months to2years,mean12months) underwent posterior radical focus debridement, bone graft andinstrumentation. The defect sites were T2in2cases,T3in3cases, T2-T36in8cases,T4～T5in5cases,T2-T4in4cases,T3～T5in2cases,T2～T5vertebrae in3cases.All patients have no large paraspinal cold abscess,18cases had nervedysfunction, According to Frankel classification to evaluate the preoperative and thelast follow-up’s nerve function. The mean preoperative kyphosis angle was18°～56°(26.78°±10.43°). Anti-TB Medication treatment was given for at least14days, then for Surgical Treatment, and the medication treatment lasted for6-18months postoperatively. All cases successfully followed up in observing operatingtime, blood loss, hospital stay, their improvement of nerve function, bone fusion, andhypnosis’ correction, ESR of recovery Etc. Result: The operations were successfullycompleted，all patients’ incision healed without complications, Such as woundinfection．The mean follow—up was18months（ranged from12to36months）．Thepatients’ clinical symptoms had different degrees of improvement,1case improvedfrom Frankel A to Frankel C,1case improved from Frankel A to Frankel D,1caseimproved from Frankel B to Frankel D, the rest improved from Frankel E. All caseswere showed bone fusion at the final follow-up，and no recurrence was noted. TheESR<20mm/h. Conclusions: Posterior radical focus debridement, bone graft andinstrumentation surgical treatment can avoid large injuries caused by anterioroperation, strengthen the stability of spine, promote bone fusion, rectify thekyphosis. |
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