| Background:This study aimed to evaluate the clinical efficacy and feasibility of surgical treatment for lower cervical spine tuberculosis by anterior debridement,fusion and instrumentation.Methods:From April 2011 to July 2016,17 patients(9 males and 8 females,average age,45.7±16.8 years)with lower cervical spine tuberculosis(C4-C7)underwent anterior debridement,fusion and instrumentation.Frankel grading and visual analogue scale were used to assess neurological function and neck pain,respectively.Operating time,blood loss,kyphosis angle,cross-sectional area of cervical spinal cord,erythrocyte sedimentation rate,C-reactive protein and postoperative complications were used to evaluate the clinical outcomes of surgery.Results:All the patients were followed up for 29 to 67 months with an average of 45.5±12.9 months.The surgery duration time range from 78 to 322 min(average 136.2±61.1 min)and the blood loss range from 50 to 500 ml(average 127.7±110.9 ml).Kyphosis angle was 10.8±11.8°on average preoperative and returned to-6.3±10.4°postoperative(P<0.001,t=12.3)and remained-4.4±9.9°at final follow-up(P<0.001,t=11.8).The cross-sectional areas of the spinal cord at C4 and C5 levels increased from 84.6±12.0 mm~2to 92.5±9.5mm~2(P=0.004,t=-3.4)and from 80.3±10.7 mm~2to 87.5±9.5 mm~2(P=0.045,t=-2.2)respectively.The cross-sectional areas of the spinal cord at C6 and C7 levels increased from 75.2±10.1 mm~2to 81.2±7.9 mm~2(P=0.004,t=-3.4)and from 65.1±13.3 mm~2to 73.4±9.5 mm~2(P=0.016,t=-2.7)respectively.The average preoperative and final follow-up visual analogue scale scores were 4.6±1.3 and 0.6±0.5 respectively(P<0.001,t=13.5).No postoperative severe complications and no recurrence of tuberculosis occurred in all cases and neurologic function was improved in various degrees.Conclusion:Anterior debridement,decompression,fusion and instrumentation could serve as an effective treatment in the management of the lower cervical spine tuberculosis. |
PDF Full Text Request