Wenping Lin1, Siyuan Wang1, Qingfeng Ke1, Xuanwei Chen2, Liqun Zhang2, Guozhong Wu1 and Jianhua Lin2*
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
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.
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.