title: [Clinical observation of anterior bone graft fusion and internal fixation to treat adjacent multivertebral tuberculosis in one-stage].
abstract: OBJECTIVE
  To evaluate the method and effectiveness of anterior focus clearance with autograft bone fusion and internal fixation in treating of adjacent multivertebral tuberculosis in one-stage.
  
  
  METHODS
  Between March 2007 and September 2009, 8 cases of thoracic vertebra tuberculosis were treated. Of 8 cases, 6 were male and 2 were female, aged 32 years on average (range, 20-42 years). The disease duration ranged from 8 to 14 months (mean, 10.2 months). Affected vertebrae included thoracic vertebrae in 35 cases and lumbar vertebrae in 11 cases; 5 vertebrae were involved in 4 cases, 6 vertebrae in 3 cases, and 8 vertebrae in 1 case. According to Frankel classification, there were 2 cases of grade C, 4 cases of grade D, and 2 cases of grade E. All patients had different kyphosis with the Cobb angle of (25.1 +/- 6.6) degrees. All patients received antituberculous therapy 4-6 weeks preoperatively; after complete clearance lesions, autograft bone fusion and internal fixation were performed, and then antituberculous therapy was given for 18 months.
  
  
  RESULTS
  All incisions healed by first intention. Eight patients were followed up 18-48 months (mean, 29 months). According to JIN Dadi et al. criterion, 7 cases recovered after first operation, 1 case of relapsed tuberculosis with sious was cured after re-focus clearance. The Cobb angle was (19.5 +/- 4.2) degrees at 7 days after operation and was (22.3 +/- 3.6) degrees at last follow-up, showing significant differences when compared with the preoperative value (P < 0.05). The nerve function of all cases were classified as Frankel grade E. CT scan showed bone graft fusion at 6-8 months after operation. No loosening or displacement of grafted bone and internal fixation occurred during follow-up.
  
  
  CONCLUSIONS
  The treatment of adjacent multivertebral tuberculosis by anterior focus clearance, intervertebral autograft, and internal fixation in one-stage is effective. Anterior bone fusion and internal fixation in one-stage can correct kyphosis effectively and rebuild spinal stability, so it is a good choice for surgical treatment of adjacent multivertebral tuberculosis.
authors: Department of Orthopedics, Guizhou Provincial People's Hospital, Guiyang Guizhou 550002, PR China. 13985026111@sina.com
authors: Weifeng
authors: W
authors: Zhao
authors: Zhuojia
authors: Z
authors: Zhou
authors: Bo
authors: B
authors: L i
authors: Jialiang
authors: J
authors: Tian
authors: Chunshan
authors: C
authors: Luo
authors: Zhi
authors: Z
authors: Peng
authors: Yuekui
authors: Y
authors: Jian
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000601:surgery*; D055815:Young Adult