Efficacy of One-Stage Posterior Debridement and Bone Grafting with Internal Fixation in the Treatment of Monosegmental Thoracolumbar Tuberculosis.

Li, Zhao-Wei; Li, Ze-Qing; Tang, Bao-Ming; Ren, Rong; Zhang, Yuan; Li, Chun-Liang; Zhang, Xue-Bin · World Neurosurg · 2019

retrospective_cohort · Level III

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Abstract

We explored the clinical effect of one-stage posterior debridement and bone grafting with internal fixation for the treatment of monosegmental thoracolumbar tuberculosis (TB). The data from 90 patients with thoracolumbar TB, who had undergone one-stage posterior debridement and bone grafting with internal fixation, were retrospectively reviewed. Data on the operative time, blood loss, length of hospital stay, erythrocyte sedimentation rate, C-reactive protein, improvement of neurological function, visual analog scale score, vertebral Cobb angle, bone healing, and complications were collected. A total of 88 patients were finally included in the present retrospective study, included 42 men and 46 women. The mean patient age was 45.4 ± 12.3 years (range, 27-70), and the mean duration of disease until treatment was 11 ± 4.5 months (range, 3-19). The mean operative time was 167.0 minutes (range, 130-210), and the mean blood loss was 767.4 mL (range, 500-1150). At the final follow-up examination, the correction in the Cobb angle was 19°, the visual analog scale score had decreased to 3 ± 1.72, the neurologic deficits using the Frankel grade had improved, and the erythrocyte sedimentation rate and C-reactive protein level had returned to normal levels. One-stage posterior debridement and bone grafting with internal fixation might be a better choice for treating patients with monosegment thoracolumbar TB.

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