Anterior tuberculosis lesion debridement and bone grafting combined with short-segment internal fixation in the treatment of thoracolumbar tuberculosis

Abstract

Study design: This was a retrospective study.

Objective: To retrospectively analyze the safety and efficacy of anterior lesion debridement and bone grafting combined with short-segment internal fixation for the treatment of patients with thoracolumbar tuberculosis. There is currently no unified standard in the academic community for surgical treatment of spinal tuberculosis. This study proposes a new surgical approach for specific thoracolumbar tuberculosis.

Methods: Patients (n = 65) who underwent anterior lesion debridement and bone grafting combined with short-segment internal fixation at our institution between January 2011 and January 2021 were included in this study. The patients were followed up for at least 2 years. During each follow-up, patients were graded using the American Spinal Injury Association (ASIA) neurologic deficit grading system, and postoperative conditions were evaluated using the Oswestry Disability Index (ODI) and pain visual analog scale (VAS).

Results: All patients successfully completed the surgery without serious complications.Four patients had unstable vital signs during the operation, 3 patients had a water-electrolyte imbalance in the postoperative period, 5 patients had transient neurological symptoms in the postoperative period, 1 patient had cerebrospinal fluid leakage after the operation, 1 patient had a transient nerve injury, and 1 patient had delayed healing. The patient with recurrence was treated regularly with quadruple antituberculosis drugs for three months after surgery and then maintained with two oral antituberculosis drugs for the following period. The CT examination was repeated half a year later, and all the indexes showed that the prognosis was good. The patients' mean postoperative VAS and ODI scores were significantly better than the preoperative scores.

Conclusion: Anterior tuberculosis lesion debridement and bone grafting combined with short-segment internal fixation in the treatment of thoracolumbar tuberculosis has certain advantages over other Surgical Procedures, and can achieve corresponding clinical results.