Ann Orthop Musculoskelet Disord | Volume 1, Issue 1 | Research Article | Open Access

Single-Stage Anterior Debridement, Autogenous Bone Grafting and Anterior or Posterior Instrumentation for Spinal Tuberculosis

Wenping Lin¹, Siyuan Wang¹, Qingfeng Ke¹, Xuanwei Chen², Liqun Zhang², Guozhong Wu¹ and Jianhua Lin^2*

¹Department of Orthopedic Surgery, The Second Affiliated Hospital, Fujian Medical University, Quanzhou 362000, China
²Department of Orthopedic Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350004, China

^*Correspondance to: Jianhua Lin 

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Abstract

The goal of this study was to discuss the indications for anterior or posterior instrumentation following radical debridement and autogenous bone grafting in patients with spinal tuberculosis over a 4-year period (2011–2015). In the current study, 71 patients (38 male and 33 female; average age, 42.4 years) were treated with single-stage anterior radical debridement, autogenous bone grafting, and anterior or posterior instrumentation. The average follow-up period was 43.8 months (range, 24–76 months). All cases had bony fusion. The average preoperative erythrocyte sedimentation rate (ESR) was 41.2 mm/h (range, 11–96 mm/h), improved to 29.0 mm/h (range, 9–57 mm/h) 1-week postoperatively, and became normal within 3 months for all patients. The average preoperative kyphosis was 16.7° (range, -19–70°), corrected to 0.7° (range, -26–22°) postoperatively, and fully improved to 3.8°(range -23–26°) at the final follow-up. The average neurological recovery in the patients was a 1.2 using the scale of Frankel et al. No severe complications occurred. Therefore, we believe that single-stage surgical management for spinal tuberculosis by anterior debridement, autogenous bone grafting, anterior or posterior instrumentation, and fusion was effective as a treatment. However, single-stage anterior or posterior instrumentation should be based on a comprehensive evaluation of the lesion segment, effectiveness of the antituberculous treatment, and imaging examination of the abscess size, scope, and degree of vertebral damage.

Citation:

Lin W, Wang S, Ke Q, Chen X, Zhang L, Wu G, et al. Single-Stage Anterior Debridement, Autogenous Bone Grafting and Anterior or Posterior Instrumentation for Spinal Tuberculosis. Ann Orthop Musculoskelet Disord. 2017;1(1):1004.