[One-stage surgical management for spinal tuberculosis].

Objective: To evaluate the clinical efficacy of one-stage surgical management for spinal tuberculosis.
Methods: Fifty-seven patients with thoracic, thoracolumbar and lumbar spinal tuberculosis were treated surgically by a single stage procedure from Jan 1996 to Jan 2001, including anterior resection, interbody outografting and anterior instrumentation in 35 cases, posterior debridement and posterior instrumentation in 16 cases, and posterior instrumentation and anterior resection plus interbody autografting in 6 cases. Titanium-alloy spinal implants were used in 38 cases and stainless steel implants in other 19 cases. Except for three patients, other 54 patients were followed up for one to five years (mean 2.2 years).
Results: All these patients had their incision healed by first intention without chronic infection or sinus formation, and no recurrence of spinal tuberculosis was noted in any patient during the follow-up period. Kyphosis correction were achieved by 21.6 degrees on the average postoperatively. There was a mild loss (2 degrees - 4 degrees) of kyphosis correction during follow-up period. Spinal solid fusion at the interface between the graft and adjacent vertebral bodies was shown radiologically in 3.8 months on the average.
Conclusion: One-stage surgical management has more advantages in that it can completes all the aspects of surgical treatment for spinal tuberculosis. Anterior or posterior instrumentation with titanium-alloy or stainless steel spinal implants is safe, The selection of one-stage surgical procedure should be planed individually.