Follow-up Study About Treatment Of Cervical Tuberculosis With Kyphosis Using Different Reconstruction

Objective:To compare the efficacy 、fusion rate and the incidence of complication of using a titanium mesh/iliac crest graft in patients with tuberculous spondylodiscitis of the cervical spine combined kyphosis.Providing reference for clinical decision making.Methods:30patients with tuberculous spondylodiscitis of the cervicalspine combined kyphosis were treated with radical debridement,decompression, anterior column reconstruction,andinstrumentation.Itconsisted of a prospectively collectedconsecutive series of 16 patients(Group A),who had reconstruction using atitanium mesh, compared to a series of 14 consecutivepatients(Group B), whohad reconstruction using an autogenous iliac crest strutgraft.The operative data were analyzed; the clinical(10 points of VAS and Frenkel classification) and radiological results(Cobb angle) were evaluated and complications related tothe surgical procedure(postoperative wound infection 、 pain of doner site、grafted bone absorption and titanium mesh sinking)were also reviewed.Using ofstatistical software SPSS 15.0 to get statistical inspection.using x2 test comparision between groups.P<0.05 was considered statistically significance.Analyze surgery and follow-up information,evaluate the clinal 、 radiological results and operation ralated complication.Results:There is no obvious differcnce in two groups of operation time(100min vs.125min),no obvious difference in blood loss(120cc vs.130cc).Neck pain VAS scores at the time of last follow-up in the two groups has significant difference(1.5 vs.2.5). Frankel classification of two groups suggests no differentduring follow-up.Titanium mesh bone grafting group shows better sagittal plane form,particalprotrusion deformity after have the orginal average15°(8°to20°),correction for-2°(4°--8°),Iliac bone graftiong by preperative13°(6°-18°)correction of-3°(2°--13°). 4 patients were found titanium mesh slight sinking,ilium group were observed bone absorption in 2 cases and 5 cases for bone pain syndromes in doner site.Conclusion:Regardless of the use of titanium mesh bone graft or autogenous iliac bone graft comblined anterior titanium plate instrument to rebuild and maintain physiological curvature anterior column provides the theretical basis of the full application of titanium mesh/iliac bone graft can be effective form of sagittal reconstruction and immediate stability can be achieved.Titanium mesh group patients show a better sagittal morphology and strong bone graft fusion without any recurrence of infection,but titanium mesh subsidence complication is higher,ilium group showed a higher incidence of bone absorption and persistent pain symptoms for bone area.