title: Anterior debridement and bone grafting of spinal tuberculosis with one-stage instrumentation anteriorly or posteriorly.
abstract: Between 2000 and 2004, 40 cases (average age 38, range 16-65 years) of spinal tuberculosis were treated with anterior debridement and iliac bone graft with one-stage anterior or posterior instrumentation in our unit. All patients received at least 2 weeks of regular antituberculous chemotherapy before surgery. We followed up all patients for 12-48 months (mean 22 months). Local symptoms of all patients were relieved significantly 1-3 weeks postoperatively; 23 of 25 cases (92%) with neurogical deficit had excellent or good clinical results. Erythrocyte sedimentation rates (ESR) returned from 51 mm/h to 32 mm/h (average) two weeks postoperatively. Kyphosis degrees were corrected by a mean of 16 degrees . Fusion rate of the grafting bone was 72.5% one year postoperatively and 90% two years postoperatively. Severe complications did not occur. We therefore believe that patients undergoing anterior debridement and iliac bone grafting with one-stage anterior or posterior instrumentation achieve satisfactory clinical and radiographic outcomes.
authors.affiliation: Department of Orthopaedics, Changhai Hospital, 174 Changhai Road, Shanghai, 200433, People's Republic of China. prof.zhao@133sh.com
authors.forename: Jie
authors.initials: J
authors.lastname: Zhao
authors.forename: Xiao Feng
authors.initials: XF
authors.lastname: Lian
authors.forename: Tie Sheng
authors.initials: TS
authors.lastname: Hou
authors.forename: Hui
authors.initials: H
authors.lastname: Ma
authors.forename: Zhi Ming
authors.initials: ZM
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001799:Blood Sedimentation; D001860:Bone Plates; D016025:Bone Transplantation / Q000295:instrumentation* / Q000379:methods*; D001915:Braces; D003131:Combined Modality Therapy; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000188:drug therapy / Q000601:surgery*
chemical_list: D000995:Antitubercular Agents