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[Function reconstruction of anterior and middle column in thoracolumbar spinal tuberculosis by one-stage anterior radical debridement]

OBJECTIVE: To summarize the effect of one-stage anterior debridement of infection in function reconstruction of anterior and middle column for the treatment of thoracolumbar spinal tuberculosis. METHODS: From January 2001 to January 2007, 65 patients with thoracolumbar spinal tuberculosis were treated with one-stage anterior debridement, decompression, autogenous bone grafts and internal fixation. There were 43 males and 22 females with an average age of 40.2 years (range, 19-64 years), including 18 cases of thoracic tuberculosis (T(4-l0)), 44 cases of thoracolumbar tuberculosis (T11-L2) and 3 cases of lumbar tuberculosis (L(3-5)). The disease course was 3 months to 10 years (median 10 months). One segment was involved in 7 cases, two segments in 54 cases and three segments in 4 cases. In 14 cases with spinal cord injury, there were 5 cases of grade C and 9 cases of grade D according to Frankel classification. The kyphotic Cobb angle was 20-65 degrees (41 degrees on average). RESULTS: The operative time was 120-210 minutes (170 minutes on average), and the blood loss was 300-1500 mL (600 mL on average). Fifty-eight patients were followed up for 1-6 years (23 months on average). Abscess occurred in 2 cases at 40 days and 3 months, and healed after symptomatic management. The other incisions achieved healing by first intention. The X-ray films showed bony fusion 4-12 months (6 months on average) after operation. No tuberculosis recurred. At 12 months after operation, pain disappeared, and there were 7 cases of grade D and 7 cases of grade E according to Frankel classification. The kyphotic Cobb angle was 0-33 degrees (24 degrees on average), showing statistically significant difference (P < 0.05) when compared with preoperation. CONCLUSION: Early reconstruction of load-bearing function and stability of anterior and middle column in the treatment of spinal tuberculosis is great significant. The application of one-stage anterior surgery with debridement, decompression, autogenous bone grafts and internal fixation in the operative treatment of thoracolumbar tuberculosis is safe and effective after a rigorous anti-tuberculosis treatment Keywords : Abscess,Adult,blood,China,classification,Debridement,Female,Fracture Fixation,Internal,Humans,injuries,Lumbar Vertebrae,Male,methods,Middle Aged,Pain,physiopathology,Spinal Cord,Spinal Cord Injuries,surgery,Thoracic Vertebrae,Time,Tuberculosis,Tuberculosis,Spinal,X-Ray Film,Young Adult,, Reconstruction,Anterior,Middle, fibromyalgia clinic

Date of Publication : 2010 Jan

Authors : Yang X;Huo H;Xiao Y;Fu Y;Xing W;Zhao Y;Feng X;

Organisation : Department of Spinal Surgery, the Second Affiliated Hospital, Inner Mongolia Medical College, Hohhot Inner Mongolia, 010030, PR China. yangxj7104@yahoo.com.cn

Journal of Publication : Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/20135968

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