[Transpedicular instrumentation and interbody fusion for spinal tuberculosis]

To evaluate the surgical outcomes of spinal tuberculosis treated with transpedicular instrumentation and interbody auto-grafting.

Thirty-four patients of thoracolumbar tuberculosis were treated with transpedicular instrumentation, radical focus resection and interbody auto-grafting, combined with 6- or 9-month antituberculous medication from October 1996 to November 1998. All patients were followed-up prospectively for 3 to 5 years postoperatively.

The back pain and tuberculous symptoms were relieved about one week postoperatively. The erythrocyte sedimentation rate came back to normal level from 4 to 6 weeks postoperatively. The solid interbody arthodesis was achieved from 4 to 6 months postoperatively. All patients were cured of tuberculous lesions in spinal column or in other region, and there were no tuberculous recurrence. In 12 patients, average preoperative kyphosis angle was 24 degrees (range 10 degrees approximately 32 degrees ), and that was 9 degrees (range 5 degrees approximately 13 degrees ) immediately after surgery. The average correction of kyphotic deformity was 15 degrees and was maintained unchanged in follow-up period postoperatively. Nine patients who had type-C or type-D neurological lesions, according to Frankel gradation, had complete recovery one year postoperatively.

In spinal tuberculous operation, transpedicular instrumentation and interbody fusion are essential in providing rigid stabilization of spinal column, correcting or preventing kyphotic deformity, accelerating focus healing up and shortening chemotherapy period. Transpedicular instrumentation is necessary in short segments fixation and preserving functional unit of spine.