Surgical Treatment with Posterior Pedicle Screw Fixation,Focal Cleaning,Titanium Mesh and Bone Graft Fusion for Multi-segmental Spinal Tuberculosis

Abstract：Objective To study the clinical effect of Surgical treatment with posterior pedicle screw fixation,focal clean-ing,titanium mesh and bone graft fusion for multi-segmental spinal tuberculosis. Methods The clinical data from 16 patients with multi-segmental spinal tuberculosis from January 2009 to December 2014 were retrospectively analyzed. There were 7 males and 9 females,ranging in age from 19 to 56 years with an average of 36. 5 years old. 2 vertebral bodies involved in 6 ca-ses,3 vertebral bodies in 7 cases,4 vertebral bodies in 2 eases,and 5 vertebral bodies in 1case. Among these cases,there were 9 cases of thoracic vertebra,5 cases of thoracolumbar vertebra,2 cases of lumbar vertebra. The kyphosis angel of diseased seg-ments was 28° to 53°,37. 6° in average. According to the Frankel classification before operation,there were Frankel A in 0 case,Frankel B in 1 cases,Frankel C in 2 cases,Frankel D in 6 cases,Frankel E in 7 cases. After intensive anti-tuberculosis medication(HRSZ)for 2 to 4 weeks before operation,all patients were treated with posterior pedicle screw fixation,focal clean-ing,titanium mesh and bone graft fusion. After operation,the anti-tuberculosis medication was continued for 12 ~ 18 months. Results The operation time ranged from 160 mins to 290 mins,215 mins in average. The blood loss ranged from 400 to 1 800 mL,780 mL in average. All the cases were followed up for 6 months to 2 years with the average of 1 year and 7 months. 1 cases was complicated with CSF leakage. No wound infection and sinus tract formation were noted. All the cases showed excellent bone graft fusion,all internal fixation had good position without looseness,displacement and breakage. The Mean kyphosis angle was 28. 2°(range,8°to 27°)after operation,with an average correction rate of 75% . Neurologic status of all patients with pre-opertative neurologic deficit was :1 with grade B recovered to grade C;2 with grade C,1 recovered to grade D and 1 recovered to grade E;6 with grade D,4 recovered to grade E and 2 did not recover. Conclusion Surgical treatment with posterior pedicle screw fixation,focal cleaning,titanium mesh and bone graft fusion for multi-segmental spinal tuberculosis is a good method pos-sessing firm fixation,excellent bone graft fusion,high safety and reliability. It has good clinical effect.