Bone graft fusion fixation for single-segment thoracic/lumbar spinal tuberculosis：effective reconstruction of spinal stabilization and deformity correction / 中国组织工程研究

ABSTRACT

BACKGROUND:On the basis of thorough debridement, homochronous anterior or staging posterior fixation has been a standard scheme for spinal tuberculosis. Numerous studies confirmed that above approach has obtained good effects, but the anterior approach has some disadvantages, such as complex anatomic structure, great trauma, relatively more complications, and difficult operation and fixator implantation. OBJECTIVE:To observe spinal stabilization and deformity correction in patients with single-segment thoracic/lumbar spinal tuberculosis after posterior debridement and interbody fusion. METHODS:Clinical data of 36 patients with single-segment thoracic/lumbar spinal tuberculosis undergoing one-stage posterior debridement and interbody fusion in the Guangxi Yulin Orthopedics Hospital of Integrated Traditional Chinese and Western Medicine from January 2008 to January 2012 were retrospectively analyzed. There were 2 cases in single T11/12 segment, 4 in T12/L1 segments, 6 in L3/4 segments, 22 in L4/5segments and 2 in L5/S1 segments. Of them, 24 patients suffered from different degrees of spinal nerve injury. At 6, 12 and 24 months after surgery, al patients were folowed up. Bone graft fusion, kyphosis correction, functional recovery of the spinal cord and complications were observed. RESULTS AND CONCLUSION:Al patients were folowed up for 24-38 months. Cobb angle of kyphosis and spinal stenosis rate were significantly improved at 2 years after treatment (P < 0.05). The lumbar back pain symptoms were significantly improved in final folow-up (P < 0.05), with an intervertebral fusion rate of 100%. No lesion residue and recurrence, correction loss, fixation loosening or displacement was found. These results demonstrated that in patients with single-segment thoracic/lumbar spinal tuberculosis, posterior debridement and interbody fusion can effectively reconstruct spinal stabilization, correct deformity, and promote the functional recovery of spinal nerves.