Single-stage Debridement With Autograft Bone Fusion And Instrumentation In The Surgical Management Of Thoracic Tuberculosis

Objective To analyze the clinical effect of single-stage debridement with autograft bone fusion and instrumentation in treating thoracic tuberculosis.Methods Thirty-six patients(18 cases of male and 18 cases of female;age 17 to 60 year-old) with thoracic tuberculosis were treated by single-stage debridement,autograft bone fusion and internal fixation from May 2005 to May 2008.T1 toT12 spinal segmental were affected.All patients had varying degrees of kyphosis,kyphosis angle 10°to 40°, an average of 21°,Twenty-two patients with neurological deficits.Before surgery,all patients received standard anti-ruberculosis chemotherapy 4 weeks.The tuberculous lesion region was completely resected,autologous iliac or rib graft was harvested to complete interbody fusion,and an instrumentation was used to reconstruct the stability of the affected segments.Anti-tuberculosis chemotherapy was continued for 12 to 18 months after surgery.Results All patients were followed up for 6 to 18 months postoperatively,with the average of 11 months.All patients with thoracic back pain reduced,a healing incision, erythrocyte sedimentation rate gradually returned to normal after one month.Of all 36 patients with preoperative kyphosis,the deformity was corrected to posterior correct angle to 0°-15°,an average of 4°,the end point of follow-up lost deformity correction of 1-4°,an average of 2°.Autogenous bone graft at 3 months after the beginning of integration,none occurred during the follow-up bone displacement,fracture collapse.Twenty-two patients with neurological deficits showed obvious improvement.None of the patients got worse.Conclusion For patients with thoracic tuberculosis,single-stage debridement with autograft bone fusion and instrumentation were found to be effective in reconstructing spine stability,arresting the disease,correcting kyphotic deformity and maintaining correction until solid spinal fusion.