The clinical evaluation of surgical treatment for spinal tuberculosis
- VernacularTitle:脊柱结核外科治疗的探讨
- Author:
Yuanzheng MA
;
Ming HU
;
Xiaojun CAI
- Publication Type:Journal Article
- Keywords:
Spine;
Tuberculosis;
Internal fixators;
Spinal fusion
- From:
Chinese Journal of Orthopaedics
2000;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical efficacy and the surgical treatment of spinal tuber-culosis by debridement, fusion and internal fixation to restore stability of the spine. Methods One hundred and fifty-two patients with spinal tuberculosis were treated surgically between 1996 and 2002. There were 15 in cervical spine, 67 in thoracic spine, 17 in thoracolumbar spine and 53 in lumbar spine. The lesion was of 1-3 levels without jumping lesions. The surgical procedures included: 1) anterior debridement, fusion with autograft and internal fixation with plate. 2) lateral debridement with posterior fusion and pedicle screw fix-ation. 3) posterior debridement, fusion and pedicle screw fixation. 4) anterior debridement and posterior fu-sion and fixation. All patients wore a brace for 3-5 months and chemotherapy was given for 6-9 months postoperatively. The blood test and imaging evaluation were undergone. All patients were followed for 3 to 5 years postoperatively. Results 1) The average operation time and blood loss was 4.5 hours and 650 ml for combined anterior and posterior procedure, 3.5 hours and 450 ml for anterior procedure and 3 hours and 350 ml for the other two procedures. 2) In regard to complications: major blood vessel injury in one case, temporary sinus formation in 5 and loosening and breaking of the instrumentation in 3. 3) All patients had relief of the symptoms and ambulation 1-2 weeks postoperatively. Normal daily function was recovered at 6-8 weeks and solid fusion was observed in 4-6 months postoperatively. All patients were cured of tubercu-losis lesions in spinal column or on other region, and there was no recurrence. Conclusion Effective chemotherapy and radical debridement of the lesion are the basis of success of surgical treatment of spinal tuberculosis. Fusion and internal fixation were the keys for restoration of the stability of spinal column, solid fusion and correction of the kyphotic deformity.
