title: Long-term outcomes of one-stage anterior debridement, bone grafting, and internal fixation for the treatment of lower cervical tuberculosis with kyphosis.
abstract: BACKGROUND
  Patients with spinal deformities and nerve compression due to spinal tuberculosis often require surgical intervention. The objective of this study was to assess the long-term therapeutic effectiveness of one-stage anterior debridement, bone grafting, and internal fixation for lower cervical tuberculosis with kyphosis.
  
  
  METHODS
  Twenty-one patients with lower cervical tuberculosis and cervical kyphosis received one-stage anterior debridement, autologous iliac bone grafting, and internal plate fixation. Patients were followed-up postoperatively for at least 5 years. Outcome measures included neck pain using Visual Analogue Scale (VAS) scores, Frankel classification of spinal cord injury, and Cobb angle of cervical kyphosis.
  
  
  RESULTS
  Eighteen patients had lesions in 2 vertebrae and 3 had lesions in 3 vertebrae. Cervical tuberculosis was cured in all patients. The mean preoperative VAS score for neck pain was 8 (range: 6-10), whereas the mean best postoperative VAS score was 0.6 (range: 0-3). Mean final VAS score was significantly higher than the best VAS score (2.14 vs. 0.62). Of the 13 patients with symptoms of spinal cord compression, 9 improved by 1 grade and 4 improved by 2 grades according to Frankel classification at final follow-up. The mean preoperative Cobb angle of cervical kyphosis was 29° (range: 15°-50°), whereas the mean postoperative Cobb angle at final follow-up was -1.8° (range: 2-7°).
  
  
  CONCLUSIONS
  One-stage anterior debridement, bone grafting, and internal fixation can effectively remove lesions, decompress the nerve, reduce pain, and correct kyphosis in patients with cervical tuberculosis and associated kyphosis. Long-term postoperative outcomes were satisfactory.
authors.affiliation: Department of Orthopaedics, Changhai Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Ningfang
authors.initials: N
authors.lastname: Mao
authors.forename: Zhicai
authors.initials: Z
authors.lastname: Shi
authors.forename: Haijian
authors.initials: H
authors.lastname: Ni
authors.forename: Yingchuan
authors.initials: Y
authors.lastname: Zhao
authors.forename: Hao
authors.initials: H
authors.lastname: Tang
authors.forename: Deding
authors.initials: D
authors.lastname: Liu
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Zhu
authors.forename: Yushu
authors.initials: Y
authors.lastname: Bai
authors.forename: Ming
authors.initials: M
authors.lastname: Li
mesh_terms: D000328:Adult; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D002574:Cervical Vertebrae; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation; D007738:Kyphosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000601:surgery; D009408:Nerve Compression Syndromes / Q000601:surgery; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D013123:Spinal Fusion / Q000379:methods; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000601:surgery*; D055815:Young Adult