Posterior mono-segmental fixation, combined with anterior debridement and strut graft, for treatment of the mono-segmental lumbar spine tuberculosis.

PURPOSE: A retrospective study was conducted to determine the beneficial effect of posterior mono-segmental fixation, combined with anterior debridement and strut graft for the treatment of mono-segmental lumbar spine tuberculosis.

METHODS

From February 2002 to February 2008, a total of 34 cases with mono-segmental lumbar spine tuberculosis were treated by posterior mono-segmental fixation, combined with anterior debridement and strut graft. The degree of damage to the patients' vertebral bodies was 1/3-2/3 height. Antituberculous therapy was performed both before and after surgery.

RESULTS

None of the patients suffered from spinal cord, nerve, great vessel or organ damage, with all patients passing through the peri-operative period successfully. Graft union was observed four to six months after surgery, with a mean of five months. In addition, no fracture or prolapsed internal fixation was found. The Cobb's angle prior to and after surgery, and at the final follow-up were 22.70 ± 9.8°, 4.5 ± 8.4° and 5.30 ± 7.10°, respectively, with a mean correction of 18.20 ± 5.8° after surgery; however, 1.70 ± 1.0° loss was observed at the final follow-up. Four cases with neurological lesions recovered to 'E' grade. At the final follow-up, all patients could live and work normally.

CONCLUSIONS

The results demonstrated that for cases with 1/3-2/3 height of vertebral body damaged in mono-segmental lumbar spine tuberculosis, treatment with posterior mono-segmental fixation, combined with anterior debridement and strut graft, can cure foci, rebuild spinal stability, reduce fused segments, and retain maximal function of the motion units.