Treatment of multi-vertebral spinal tuberculosis by posterior instrumented fusion with short segment pedicle screws fixed on pathologic vertebrae

doi:10.3969/j.issn.1000-6621.2014.08.013

Abstract

Abstract: Objective To evaluate the feasibility of treatment of multi-vertebral spinal tuberculosis by posterior instrumented fusion with short segment pedicle screws fixed on pathologic vertebrae. Methods Thirty-two patients with spinal tuberculosis of 2 or more vertebral body destruction, who were admitted in Beijing Chest Hospital Capital Medical University from July 2010 to July 2012, confirmed by surgery and follow-up completed. According to the nerve function classification standard from American Spinal Injury Association(ASIA), there were grade A: 2 cases, grade B: 1 case, grade C: 7 cases, grade D: 14 cases and grade E: 8 cases. The Cobb angle were compared with pre- and postoperative short segment pedicle screws fixation at the end of the second and the eighteenth month. The excellent and good rate of operation was evaluated according to the marking standard from Japanese Orthopaedic Association(JOA). The recovery of nerve function pre- and postoperation and postoperative complications were observed. Results All patients were followed-up completely at least 2 years and no patients were relapsed in this period. Meanwhile, no patients were observed with pus, sinus tract formation and complications associated with pedicle screw implantation. The Cobb angle became smaller obviously at the end of two weeks from (19.8±6.1) degree preoperation to (7.8±3.1) degree postoperation(t=9.9，P=0.00) and at the end of eighteenth month from (7.8±3.1) degree postoperation to (8.8±4.3) degree postoperation(t=1.2，P=0.09). The score of JOA was improved obviously from (8.7±6.3) to (25.2±2.8) (t=13.6，P=0.00). The improvement rate was 75.0%(24/32). The ASIA classification was grade D 7 cases and grade E 25 cases after operation. Conclusion The short segment pedicle screws fixed on pathologic vertebrae to treat multi-vertebral spinal tuberculosis is not only satisfactory on efficacy, but also reduces Cobb angle loss and improves comfortableness. It is worth to extend application.

Key words: Tuberculosis, spinal/surgery, Bone nails, Internal fixators, Spinal fusion

FAN Jun，QIN Shi-bing，DONG Wei-jie，LAN Ting-long，XU Shuang-zheng，TANG Kai. Treatment of multi-vertebral spinal tuberculosis by posterior instrumented fusion with short segment pedicle screws fixed on pathologic vertebrae[J]. Chinese Journal of Antituberculosis, 2014, 36(8): 666-670. doi: 10.3969/j.issn.1000-6621.2014.08.013

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