Wedge Osteotomy Combined Interbody Granule Bone Grafting For Treatment Of Active Thoracic And Lumbar Tuberculosis

Objective: The purpose of this study was to investigate the clinical outcomes and operation indication of one-stage posterior debridement,wedge osteotomy,combined interbody granule bone grafting and compressive fusion in the treatment of active thoracic and lumbar tuberculosis.Methods: There were 19 men and 11 women with an average age of 45�18 years(range,19~76)diagnosed with thoracic or lumbar tuberculosis underwent the operation.VAS(visual analogue scale)grade and ASIA(American Spinal Injury Association spinal cord injury grade)were evaluated preoperatively and at final follow-up.X-rays,ESR,and CRP were evaluated every 3 months postoperatively.Results: The follow-up period range from 16~60 months(mean 24�5 months).The operation time range from 120~200 min(mean 157 � 97 min).The intraoperative blood loss range from 200~800 ml(mean 380�190ml).The bone fusion was chieved in all patients.bone fusion time range from 5~9 months(mean 6.3�2.3 months).ASIA was preoperatively grade B in 1,grade C in 2,grade D in 14,and grade E in 13,which improved to grade D in 5 and grade E in 25 at final follow-up.The kyphosis Cobb angle was 40.1��8.1�preoperatively,12.0��7.0� immediately after operation,and 15.1��6.9� at final follow-up with a mean Cobb angle loss of 3.1��1.4� during the follow-up period,showing significant difference between the preoperative and final follow-up Cobb kyphosis angle(t=6.32,P<0.05).Conclusion: One-stage posterior debridement,wedge osteotomy,combined interbody granule bone grafting and compressive fusion is an effective and safe method in the treatment of active thoracic and lumbar tuberculosis with severe kyphosis.However,more research is needed to verify its clinical outcomes and seek out the exact surgical indications.