One-stage anterior interbody autografting and instrumentation in primary surgical management of thoracolumbar spinal tuberculosis

摘要: There are few articles in the literature concerning anterior instrumentation surgical management of spinal tuberculosis exudative stage. So we report here 23 cases active thoracolumbar treated by one-stage interbody autografting and to verify importance early reconstruction stability evaluate results stage throracolumbar tuberculosis. Twenty-three patients, including two children (9 15 years old, respectively) 21 adults with were surgically. T9 L4 segments affected, MRI/CT showed evident collapse vertebrae because tuberculous destruction paravertebral abscess. Neurological deficits found 15 patients. Before surgery, patients received standard anti-tuberculosis chemotherapy for 2 3 weeks. Under general endotracheal anaesthesia, placed right recumbent positions, a transthoracic, lateral extracavitary or extrapleural approach was chosen according lesion segment. After exposure, region, collapsed in-between intervertebral disc, almost completely resected order release segmental cord. Then, autologous iliac, rib fibular graft harvested complete fusion, an titanium-alloy plate-screw system used reconstruct affected segments. Anti-tuberculosis continued at least 9 months, supported thoracolumbosacral orthosis 6 months after surgery. All followed up average 2 years. healed without chronic sinus formation any recurrence during follow-up period. Spinal fusion occurred mean 3.8 months Of all neurological deficits, 14 obvious improvement; only one patient Frankel C remained unchanged, but none got worse. During period, 18 degrees kyphosis correction achieved surgery adult group. Moderate progressive this procedure postoperatively 9-year-old child 1/2 years; another 15-year-old did not demonstrate phenomenon. Except loosening screw (which affect stability), no other complications associated follow-up. Early plays important role One-stage show more advantages selected supplementary posterior should be considered prevent postoperative when is performed children.