| Objective:To analyze the clinical effect of single-stage anterior debridement with autograft bone fusion and instrumentation in treating thoracic and lumbar tuberculosis.Methods:Fourty-eight patients( 28 male and 20 female; average age, 43.9years ) with thoracic and lumbar tuberculosis were treated by single-stage anterior debridement , autograft bone fusion and internal fixation from August 2003 to August 2007. T3 to L5 spinal segments were affected. Neurological deficits were found in 14 patients. Before surgery, patients received standard anti-tuberculosis chemotherapy for 2 to 4 weeks. The tuberculous lesion region was completely resected, autologous iliac or rib graft was harvested 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.Results:All patients were followed up for 6 to 54 months postoperatively,with the average of 26.4 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. Of all 48 patients with preoperative kyphosis, the deformity was corrected from an average of 24.6°to an average of 12°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, 13 patients showed obvious improvement;while one patient with Frankel D lesion remained unchanged, but none of the patients got worse.Conclusion:For patients with thoracic and lumbar tuberculosis,single-stage anterior debridement with autograft 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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