Compare of complete and incomplete radical debridement for thoracolumbar spinal tuberculosis / 中华骨科杂志

ABSTRACT

Objective To explore the compare of complete and incomplete radical debridement for thoracolumbar spinal tuberculosis.Methods Data of 296 patients with spinal tuberculosis from January 2000 to January 2011 were retrospectively analyzed.All patients were divided into two groups according to completeness of debridement:complete debridement group (group A) and incomplete debridement group (group B).There were 162 cases in group A including 86 males and 76 females,with an average age of 38.74± 17.26 years.There were 134 cases in group B including 73 males and 61 females,with an average age of 35.64± 18.21 years.All paticnts had undergone anterior debridement,focal graft implantation,anterior or posterior deformity correction,and internal fixation.Regular follow-up was required in the two groups.Results Residual sclerotic walls (36.54％),multipie cavities (34.62％),affected bony bridges (13.46％),sequestmm (3.37％),abscess (7.21％) and other lesionses (4.81％) were found in the group B.The first three factors were made up 84.62％ of the total.The mean follow-up time was 76.13±8.32 months in the group A and 79.24±5.49 months in the group B.The symptoms,C-reactive protein and erythrocyte sedimentation rate were improved more obviously in group A than those in group B.Six months after operation,tuberculosis healing rate in group A and group B was 29.01％ (47 patients) and 4.48％ (6 patients),respectively.The mean healing time was 4.36± 1.27 months in the group A and 9.15±2.53 months in the group B,with significant differences.The mean the time of chemotherapy was 5.21± 1.38 months in the group A and (10.45±2.15) months in the group B,with significant differences.Reoperation rate in group A and group B was 0.62％ (1/162) and 4.48％ (6/134),respectively.Conclusion Sclerotic bone,multiple cavities,and bony bridges are parts of foci in spinal tuberculosis.Clearing tuberculous foci with sclerotic bone,multiple cavities,and bony bridges can increase the curative effect,shorten the time of chemotherapy and reduce the side effects of drug,thus early resumption can be achieved.