Risk factors of cage subsidence after single level transforaminal lumbar interbody fusion / 中华骨科杂志

Objective To investigate the relationship between clinical efficacy and cage subsidence,and to identify the risk factors of cage subsidence after transforaminal lumbar interbody fusion (TLIF) in treating single level lumbar disc herniation and lumbar spondylolisthesis.Methods According to the inclusion/exclusion criteria,a series of 107 patients who underwent TLIF with polyetheretherketone (PEEK) cage in our department were evaluated retrospectively between May 2011 and May 2014.Intervertebral space height and segmental angle were measured on the preoperative and postoperative iconography according to the metrical software.All patients were divided into cage subsidence group (cage subsidence ≥ 2 mm) and cage non-subsidence group (cage subsidence ＜ 2 mm) based on the threshold value of intervertebral space height via X-ray.The Oswestry disability index (ODI) and visual analogue scale (VAS) was used to evaluate the clinical efficacy.Univariate analysis and logistic regression analysis were performed to identify the potential risk factors.Results Of all 107 patients,thirty-six patients (15 males and 21 females)aged 52.61 ± 13.82 years were divided into in the cage subsidence group with an average follow-up duration 26.33±7.66 months,seventy-one patients aged 53.80± 14.94 years,28 males and 43 females in the cage non-subsidence group,were followed-up for 23.82±8.95 months.There was no significant difference between cage subsidence group and cage non-subsidence group in gender,age,course of disease and time of follow-up (P＞ 0.05).The average 2.79±0.78 mm (range 2.02-5.53 mm) subsidence was observed in cage subsidence group.The preoperative intervertebral space height,postoperative intervertebral space height,postoperative segmental angle were related to cage subsidence by univariate analysis (P ＜ 0.05).Postoperative intervertebral space height [OR=1.864,95％CI(1.207,2.879) mm] was the risk factor of cage subsidence by logistic regression (P ＜ 0.05).There was no significant difference between cage subsidence group and cage non-subsidence group in ODI and VAS (P ＞ 0.05).Conclusion Cage subsidence is affected by the preoperative intervertebral space height,postoperative intervertebral space height,and postoperative segmental angle.Postoperative intervertebral space height is the independent risk factor of cage subsidence.Over distraction of intervertebral space height could increase the risk of cage subsidence.

The role of ABCG2 in the sensitivity of glioma to pyropheophorbide-amethyl ester-mediated photodynamic therapy / 中国癌症杂志

Background and purpose:Adenosine triphosphate-binding cassette superfamily G member 2 (ABCG2), which has been found over-expressed in a variety of cancer cells, takes part in the drug resistance of cancer through effux of anticancer drugs. The purpose of this study was to investigate the mechanisms of human glioblastoma cells sensitivity to pyropheophorbide-a methyl ester (MPPa)-mediated photodynamic therapy (PDT) eradicating tumour cells and its relationship to ABCG2.Methods:U87 and A172 glioma cell lines in the logarithmic growth phase were selected and exposed to the treatment of MPPa-PDT and MPPa-PDT+fumitremorgin C (FTC) respectively. The cell viability was measured with the use of CCK-8 assay. The expression of ABCG2 was detected by Western blot. The intracellular contents of MPPa in each group without illumination were tested by lfow cytometry. Flow cytometry with AnnexinⅤ-FITC/PI double staining was used to detect the cell apoptotic rate. DCFH-DA staining was used to assess the generation of intracellular reactive oxygen species (ROS).Results:The MPPa-mediated PDT could eradicate A172 and U87 cancer cells in an energy-dependent manner. The light energy density in A172 was 8 times of that in U87 when the cell viability reached median lethal dose after MPPa-mediated PDT. The high expression of ABCG2 in A172 cells affected the accumulation of intracellular MPPa. Inhibition of ABCG2, not only could enhance the eradicating effect of MPPa-PDT on A172 cells, but also could increase the yield of ROS triggered by MPPa-PDT and the accumulation of intracellular MPPa.Conclusion:The human glioblastoma cell line A172 is insensitive to MPPa-mediated PDT. The mechanism may relate to ABCG2, which decreases the MPPa content in cancer cells through effux of MPPa, resulting in decline of cytotoxicity.

Vertebral corpectomy combined with long-segmental instrumentation of Denis type D and E severe unstable thoracolumbar burst fracture / 中华创伤杂志

Objective To evaluate the feasibility and clinical effect of stage Ⅰ posterior vertebral corpectomy filled with titanium mesh cages plus long-segmental instrumentation for treatment of Denis type D and E severe unstable thoracolumbar burst fracture.Methods A retrospectively review was made on 14 patients with Denis type D and E severe unstable thoracolumbar burst fracture,having had posterior vertebral corpectomy,titanium mesh bone grafting and long-segmental pedicle screw fixation.Parameters recorded were operation time,amount of bleeding,bone fusion and reduction,postoperative complications,low back pain,neurological performance,restoration and loss of anterior vertebral height,correction and loss of kyphosis,and intraspinal space occupying lesion.Results Mean operation time was 207.1 min (range,148-306 min) and blood loss was 585 ml (range,300-1,500 ml).Intraoperative fracture reduction was satisfactory.Follow-up ranged from 18 to 54 months (mean,28 months),which showed no complications of infection,screw-rod breakage,loosening or shifting of the internal fixation device,titanium mesh subsidence and pseudarthrosis,and no signs of adjacent segment degeneration.Six months after operation,CT scan showed bony fusion of the bone-implant interface.At the final follow-up,the Denis pain scale improved significantly including 12 patients with completely relieve of pain (P1) and 2 ache slightly but no need of taking painkiller (P2).Neurological functions were improved by 1-3 degree in all patients.Percentage of anterior vertebral height was (41.2 ± 8.9)％ before operation,significantly reduced to (8.3 ± 4.8) ％ one week after operation and to (8.9 ± 5.1) ％ at the final follow-up (P ＜0.01).Mean loss of anterior vertebral height was 0.6％.Sagittal kyphotic angle was (36.9 ± 4.9) °before operation,significantly reduced to (8.1 ± 3.4) ° one week after operation and (8.5 ± 3.8) °at the final follow-up (P ＜0.01).Mean loss of kyphotic angle was 0.9°.Ratio of intraspinal space occupancy was (74.9 ± 11.3) ％ before operation but recovered to (4.1 ± 1.6) ％ one week after operation and (1.8 ± 1.4) ％ at the final follow-up,with significant differences in pair comparison (P ＜ 0.01).Conclusion The use of posterior vertebral corpectomy and fusion with titanium mesh cage fusion in conjunction with long-segment instrumentation are effective for spinal canal decompression,fracture reduction,three-column reconstruction as well as rigid fusion at one stage,lumbar pain relief,neurological function recovery,prevention of correction loss and vertebral height restoration.

Early clinical effect of intervertebral fusion of lumbar degenerative disease using nano-hydroxyapatite/polyamide 66 intervertebral fusion cage / 生物医学工程学杂志

The present study is aimed to investigate the early clinical effects of nano-hydroxyapatite/polyamide 66 intervertebral fusion cage (n-HA/PA66 cage) for the treatment of lumbar degenerative diseases. We selected 27 patients with lumbar degenerative diseases who were managed by posterior decompression or reset operation combined with n-HA/PA66 cage intervertebral fusion and internal fixation from August 2010 to January 2012. The oswestry disability index (ODI), low back and leg pain visual analogue score (VAS), and intervertebral height (IH) were evaluated at preoperation, 1 week postoperation and the last follow-up period, respectively. Intervertebral bony fusion was evaluated at the last follow-up time. The patients were followed up for 12-24 months (averaged 19 months). The ODI, VAS and IH were significantly improved at 1 week postoperation and the last follow-up time compared with those at preoperative period (P < 0.05). But there was no significant difference between 1 week postoperative and the last follow-up time (P < 0.05). Brantigan's standard was used to evaluate fusion at the last follow-up time. There were 19 patients with grade 5 fusion, 8 with grade 4 fusion, with a fusion rate of 100%, and none with grade 1-3 fusions. There was no cage translocation and internal fixation breakage. These results suggested that n-HA/PA66 cage was an ideal biological material in the posterior lumbar interbody fusion and internal fixation operation for treatment of lumbar degenerative diseases. It can effectively maintain the intervertebral height and keep a high rate of bony fusion. The early clinical effect has been satisfactory.

Schema theory in culturing medical English reading ability of medical postgraduate / 中华医学教育探索杂志

For better adaptation to clinical work and scientific research as well as self-development,medical postgraduates are required to improve their reading ability to harvest information from medical English articles.Constructing formal schema based on linguistic schema and enriching content schema can significantly enhance medical English reading ability,according to schema theory and education practice.Therefore,the learning mode was explored based on schema theory and this theory was applied in practice to elevate reading ability by means of reading report.

Reoperation for thoracolumbar fracture combined with spinal cord injury / 中华创伤杂志

Objective To evaluate the outcome of reoperation(after I stage anterior/posterior operation)for thoracolumbar fractures combined with kyphosis and spinal cord injury. Methods A retrospective study was done on the medical records of 12 patients who underwent two-stage decompression with kyphosis and neurologic deficit due to single-stage approach(anterior or posterior) operation of thoracolumbar fractures combined with spinal cord injury between January 2005 and April 2009.There were 9 males and 3 females,at mean age of 34.6 years(range,19-57 years).According to the Denis classification,there were five patients with burst fractures,five with compression fractures and two with fracture dislocation.All the patients had couns medullaris injury.Of all the patients,five underwent one stage anterior approach surgery and the others underwent posterior approach operation.All the patients had vailous degrees of neurological symptoms.The patients treated with one stage anterior surgery were treated with two stage posterior surgery and the patients treated with one stage posterior surgery were treated with the two stage anterior operation.The mean interval from one stage operation to two stage decompression was 13.4 months(range,12-18 months).The radiologic,neurologic and functional outcomes were assessed through observation of the Cobb angle,Frankel spinal cord injury grading and Japanese Orthopaedic Association Scores(JOA). Results AIl the patients were followed up for mean 25 months (12-48months),which showed primary healing of the incisions in all the patients.The average anterior and posterior heisht of the vertebrae wers corrected from preoperative 42.6%and 70.5%to postoperative 92.5%and 95.7%and to 87.3%and 92.2%at the final follow-up respectively.Neurologic status was improved at least one Frankel grade in the patients who had preoperative incomplete paraplegia.The Cobb angle was corrected from preoperative 36.3°to postoperative 5.8°and to 5.9°at the final follow-up(P<0.05).No patient had any notable loss of correction between discharge and final follow-up.According to JOA coring,the results were excellent in nine patients,good in two and fair in one,with excellence rate of 92%. Conclusions Two stage decompression for epiconus and cauda equina syndrome resulted from one stage approach(anterior or posterior)operation of thoracolumbar fractures combined with spinal cord injury call attain satisfactory correction of the kyphosis and nerve decompression as well as various degrees of nerve function recovery.

Application of Mimics and rapid prototyping in atlantoaxial pedicle placement / 中华创伤杂志

Objective To develop and validate a novel method of atlantoaxial pedicle screw placement by using three-dimensional reconstruction software Mimics and rapid prototyping. Methods Three-dimensional reconstruction of 20 CT scanned cadaver atlantoaxial specimens was performed by using Mimics and the parameters of the pedicles were measured. Then, physical model of the pedicles was manufactured by using rapid prototyping and the parameters of the cadaver pedicles were measured. The parameters of the atlantoaxial pedicle were directly measured. All the data were analyzed statistically to verify the accuracy of the reconstructed images and physical models. The optimal pedicle channel was found to design individual fixation parameters, based on which fixation of cadaver specimens was performed under direct guidance of physical model. The accuracy of fixation was assessed by CT scanning. Results There was no statistical difference in parameters of the reconstructed images, the physical model and the specimens, which could reflect accurate atlantoaxial anatomy. Postoperative CT scanning showed that the pedicle screws were inserted successfully in 16 sides of four specimens, except for one screw wearing medial bone cortex of the atlas artery. Conclusions Three-dimensional reconstruction of the atlantoaxial specimens by using Mimics and physical models made by rapid prototyping technology facilitate atlantoaxial pedicle screw placement and can enhance the accuracy of screw fixation.

Preliminary application of the fusion cage of biomimetic n-HA/PA66 composites in anterior cervical intervertebral fusion / 生物医学工程学杂志

This study was aimed to evaluate the preliminary efficacy and the safety of the fusion cage made of biomimetic nano-hydroxyapatite and polyamide 66 (n-HA/PA66) composites for the structural reconstruction and the restoration of height of vertebral body in the case of cervical spondylosis by anterior surgical procedures. 52 patients with cervical spondylosis, received the therapy by discectomy with or without vertebrae resection and decompression, and the fusion cage of n-HA/PA66 vertebra implant with bone chip, and titanium plate system was fixed. All cases were followed up for 6 to 25 months. All the patients' preoperative symptoms subsided without any serious complication, and no patient complained of lasting soreness. No effusion or flare was found, and no recurrence happened in the follow-up. The preoperative JOA score was 10.4, and post-operative JOA score 15.7. The X-ray films of all cases demonstrated successful fusion with good curvature and height, and there was no sinking or collapse. The stability was satisfactory; the reconstructive height of vertebra was maintained. No complications such as infection and screw broken came into being. The fusion cage of the biomimetic n-HA/PA66 composites can effectively restore the height and structure of vertebra. It may have the potential for use as a satisfactory prosthestic vertebral body replacement.

Characteristics of chondrocyte scaffold carriers for cell-based gene therapeutic repair of articular cartilage / 中华创伤杂志

Objective To characterize the viability and transgene expression of articular chon-drocytes cultured in 3-Dimensional scaffolds provided by four types of carriers.Methods Articular chondrocytes from rabbit knees were cultured and infected with adenovirus that could express green fluo-rescence protein (AdGFP) and GL3 luciferase (AdGL3-Luc).The viability and gene expression were determined with fluorescence microscopy and luciferase assays in four types of scaffolds;type I collagen sponge, fibrin glue, hyaluronan and open-cell polylactic acid (OPLA).Cartilage matrix production was assessed by Alcian blue staining.Results Articular chondrocytes of rabbits were effectively infected by AdGFP and exhibited sustained GFP expression.All the tested scaffolds supported the survival and gene expression of the infected chondrocytes.However, the highest transgene expression was observed in the OPLA carrier (P<0.01).Alcian blue-positive matrix materials were readily detected in OPLA cultures four weeks later.Conclusion OPLA supports the highest transgene expression and is the most conduc-tive scaffold for matrix production, suggesting that OPLA may be a suitable scaffold for cell-based gene therapy of articular cartilage repair.

Application of Artificial Vertebral Body of Biomimetic Nano-Hydroxyapatite/Polyamide 66 Composite In Anterior Surgical Treatment of Thoracolumbar Fractures / 中国修复重建外科杂志

Objective To study the clinical effects of the artificial vertebral body of the biomimetic nano-hydroxyapatite/polyamide 66 (n-HA/PA66) composite for the structural reconstruction and the height restoring of the vertebral body in the thoracolumbar fractures by the anterior surgical procedures. Methods From December 2003 to January 2006, 42 patients with thoracolumbar fractures received the anterior surgical procedures to decompress and reconstruct the spinal vertebral structure with the artificial vertebral body of the n-HA/PA66 composite. Among the patients, there were 28 males and 14 females, aged 17-67 years, averaged 43.6 years. The thoracolumbar fractures developed at T12 in 5 patients, at L1 in 17, at L2 in 14, and at L3 in 6. The height of the anterior border of the vertebral body amounted to 29%-47% of the vertebral body height, averaged 40.6%. The Cobb angle on the sagittal plane was 21-38° averaged 27.6°. According to the Frankel grading scale, the injuries to the nerves were as the following: Grade A in 7 patients, Grade B in 19, Grade C in 8, Grade D in 6, and Grade E in 2. Results All the 42 patients were followed up for 6-25 months. Among the patients, 36 were reconstructed almost based on the normal anatomic structure, and 6 were well reconstructed. The mean height of the anterior border of the vertebral body was 40.6% of the vertebral body height before operation but 91.7% after operation. And the reconstructed height of the vertebra was maintained. The mean Cobb angle on the sagittal plane was 27.6°before operation but 13.4° after operation. All the patients had a recovery of the neurological function that had a 1-grade or 2-grade improvement except 7 patients who were still in Grade A and 2 patients who were in Grade D. The implant was fused 3-5 months after operation. No infection, nail break, bar/plate break or loosening of the internal fixation occurred. Conclusion The artificial vertebral body of the biomimetic n-HA/PA66composite can effectively restore the height and the structure of the vertebra, can be fused with the vertebral body to reconstruct the spinal structural stability effectively, and can be extensively used in the clinical practice.

Functional reconstruction of cervical vertebra in patients with cervical spinal stenotic myelopathy through expansive open-door laminoplasty / 中国组织工程研究

BACKGROUND:The main method to treat cervical spinal stenotic myelopathy caused by various factors is posterior lamninectomy, but the postoperative effect was not satisfactory.OBJECTIVE: To observe the postoperative functional reconstruction of the cervical vertebra of the patients with cervical spinal stenotic myelopathy through expansive open-door laminoplasty.DESIGN: An observational study by comparing the changes before and after the operation.SETTING: Department of Orthopaedics of the First Affiliated Hospital of Chongqing Medical University.PARTICIPANTS: Totally 32 patients (22 male and 10 female) with multi-segment cervical spinal stenotic myelopathy were treated at the Department of Orthopaedics of the First Affiliated Hospital of Chongqing Medical University from May 1995 to May 2004. Twelve cases suffered from degenerative spinal canal stenosis caused by spinal cord type of cervical spondylosis, 18 cases suffered from developmental spinal canal stenosis and 2from ossification of cervical posterior longitudinal ligament (OPLL).METHODS: Altogether 32 cases were treated through expansive opendoor laminoplasty to the cervical spine. These patients had been followed up for 6 months after the informed consent was obtained. The spinal function was evaluated according to Japanese Orthopaedic Association 17scores before operation, 2 weeks and 3 months after the operation respectively. The radian of the cervical vertebra, the stability of the spinal column and the complications were observed with X-ray.bility of the spinal column and the complications after the operation.RESULTS: According to intention-to-treat analysis, all the 32 patients entients before and after the operation: According to the evaluation standard stipulated by Japanese Orthopaedic Association (JOA), two weeks and three months after the operation, the scoring of the spinal function was significantly higher in 12 cases of cervical spondylosis myelopathy-induced degenerative stenosis, 18 cases of developmental spinal stenosis and 2 cases of ossification of cervical posterior longitudinal ligament (OPLL)( The score was 5.2, 5.7, 5.5 points respectively before the operation; 9.2, 9.7 , 9.4points respectively 2 weeks after the operation; and 11.3 , 11.8 , 11.6dian of the cervical vertebra, the stability of spinal column, and the complications after the operation: Radiographs indicated vanished cervical anteflexion curvature and straightened cervical vertebrae in three cases, but no re-closure or unstable spine happened.CONCLUSION: Expansive open-door laminoplasty for cervical spinal canal stenosis caused by various factors can still improve and increase the spinal functional evaluation scores shortly and 3 months after the operation, and it does not affect the stability of the cervical vertebrae.

Anterior radical debridement and interbody autografting with internal fixation for the treatment of thoracolumbar spinal tuberculosis / 重庆医科大学学报

Objective:To evaluate the clinical efficacy of radical debridement and spinal fusion with internal fixation and to discuss the safety of anterior instrumentation in surgical management in thoracolumbar spinal tuberculosis.Methods:There were 16 cases in this series.The mean age was 45 years.16 cases of thoracolumbar spinal tuberculosis were radical focus debrided and grafted with iliac bone.8 cases were fixed with TSRH,3 cases with Ventrofix and 5 cases with Z-plate.No brace was needed after surgery.Results:The period of follow-up lasted 19 months.All patients had good results.The incision of all cases were cured for the first term.No case had sinus.13 degree of the kyphosis deformity was improved without associated complication.All patients had no recurrence of tuberculosis.Conclusion:The results show that the radical focal debridement and anterior bone transplantation with internal fixation can reconstruct the spinal stability and it is safe to implant anterior instrumentation in tuberculosis foci.

Direct anterior fixation of odontoid fractures with hollow screw / 第三军医大学学报

Objective To evaluate the application and efficacy of direct anterior fixation of odontoid fractures with hollow screw.Methods From March 2001 to January 2006,13 patients with odontoid fractures were treated by direct anterior fixation with hollow screw.Results Of the 13 patients,except 2 patients with postoperative temporary dysphagia, 11 had excellent results.The follow-up was ranged from 9 to 18 months,with an average of 12.5 months.The odontoid fractures acquired fusion,and no unstability or pseudoarthritis was found. Conclusion The technique of direct anterior fixation with hollow screw is an efficacious means in the treatment of odontoid fractures.The meticulous surgical technique along with appropriate patients selection will be the key to successful surgery.

Anterior debridement and primary interbody autografting with internal fixation in treatment of cervical vertebra tuberculosis / 第三军医大学学报

Objective To evaluate the clinical efficacy and surgical method in radical debridement and spinal fusion with internal fixation in surgical management of cervical vertebra tuberculosis.Methods Twenty-one patients of cervical vertebra tuberculosis were included,mean age of 31 years,including 2 cases at C_(1-2),3 at C_(2-3),9 at C_(4-5),3 at C_(5-6),3 at C_(6-7),1 at C_7T_1.After all patients underwent radical debridement of focuses,15 cases were grafted with iliac bone and 6 with titanium mesh,19 cases were fixed with plate,1 case with Apofix,1 case with Occipital-cervical fusion.The external fixation was needed for 3 months after surgery.Results The follow-up lasted for 21 months.One case grafted with titanium mesh failed,but other patients achieved satisfactory results of successful interbody fusion within 3 to 6 months.The kyphosis deformity was corrected to normal condition without associated complications.The neural symptoms were improved.All patients had no recurrence of tuberculosis.There were no plates and screws broken.Conclusion It is safe and effective to treat cervical vertebra tuberculosis by anterior radical debridement and primary autograft by internal fixation,with high correction rate of local kyphosis deformity,high fusion,and low complication rate.

Posterior transpedicular screw system internal fixation and anterior radical focus debridement with interbody autografting in the treatment of lumbar and sacrum spinal tuberculosis with kyphosis deformity / 重庆医科大学学报

Objective:To evaluate the clinical efficacy of posterior transpedicular screw system internal fixation and anterior radical focus debridement with interbody autografting in the treatment of low lumbar and sacrum spinal tuberculosis with kyphosis deformity.Methods:There were 17 cases of low lumbar and sacrum spinal tuberculosis with kyphosis deformity in this series,including 1 case of L3,4 cases of L4,3 cases of L5,3 cases of L3~4,4 cases of L4~5 and 2 cases of L5S1.The mean age was 37 years.All cases received posterior transpedicular screw system internal fixation,anterior radical focus debridement and autografting with iliac bone.Bed rest was for 8 weeks after surgery and no brace was needed.Anti-tuberculosis treatment lasted 12~18 months.Results:The mean period follow-up was 23 months.All patients achieved satisfactory results,and showed successful interboby fusion within 3~6 months.The kyphosis deformity was corrected and the normal low lumbar and sacrum lordosis were maintained without associated complication.All patients had no focus recurrence of tuberculosis.There were no internal implant complications.Conclusion:It is a safe and effective method to treat low lumbar and sacrum spinal tuberculosis with kyphosis deformity by posterior transpedicular screw system internal fixation and anterior radical focus debridement with iliac bone grafting.

Surgical treatment of posterior approach for spondylodiscitis after lumbar discectomy / 重庆医科大学学报

Objective:To discuss the surgical management of spondylodiscitis after the lumbar discectomy.Methods:7 cases of spondylodiscitis after the lumbar discectomy were analysed retrospectively.All patients were treated with surgical management of posterior approach combined with antibiotics.Results:In 7 patients,4 were males and 3 females.The mean age was 45 years old.The spinal segment involved included L 4/5 in three and L 5S 1 in four cases.The history, clinical courses,ESR and MRI are very useful in the diagnosis of postoperative spondylodiscitis.3 cases presented positive in the bacterial culture and 4 cases negative.After the surgery of the posterior focal debridement and bone plantation with internal fixation, the symptoms were relieved in a short period of time.The roentgenographic followe-up showed the spinal fusion 2.5～3.5 months after surgery.Conclusion:The surgical management of the posterior approach has more advantages over the anterior approach.It is one of the most effective methods for treatment of the spondylodiscitis after lumbar discectomy.

Anterior radical debridement and interbody autografting with internal fixation in the treatment of cervical spinal tuberculosis with kyphosis deformity / 重庆医科大学学报

Objective:To evaluate the clinical efficacy of radical debridement and spinal fusion with internal fixation in surgical management of cervical spinal tuberculosis with kyphosis deformity.Methods:There were 14 cases in this series.The mean age was 32 years.14 cases of cervical spinal tuberculosis were radical focus debrided and grafted with iliac bone.5 cases were fixed with Orion,4 cases with Zephir,4 cases with Codman and 1 case with Apofix.The brace was needed for 3 months after surgery.Results:The period of follow-up lasted 21 months.All patients achieved satisfactory results,and showed successful interboby fusion within 3～6 months.The kyphosis deformity were corrected and the normal cervical lordoisis were maintained without associated complication.The neural symptoms were improved.All patients had no recurrence of tuberculosis.There were no plates and screws complications.Conclusion:It is safe and effective to treat cervical spinal tuberculosis by anterior radical debridement with primary autograft and internal fixation,and it is a good treatment option with high correction rate in local kyphosis deformity,high fusion,and low complication rate.