Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P108. A Multicenter retrospective research of anterior debridement, decompression, bone grafting, and instrumentation for cervical tuberculosis

Abstract

BACKGROUND CONTEXT The incidence of cervical tuberculosis is not high, and only accounts for 3%–5% of spinal tuberculosis. However, the cervical anatomy is complicated, with many of the lesions being adjacent to important structures. The disease has a high risk and high disability rate, which seriously affects the prognosis and quality of life of the patients. Some scholars reported the incidence of paralysis in cervical tuberculosis to be as high as 42.5%. In recent years, anti-tuberculosis drugs in the treatment of spinal tuberculosis are more standardized, and also achieve a good therapeutic effect, but the spinal instability, kyphosis, nerve dysfunction and other complications often occur at follow-up. PURPOSE To observe the clinical effect of anterior debridement, decompression, bone grafting, and instrumentation for cervical spinal tuberculosis in four hospitals. STUDY DESIGN/SETTING A retrospective cohort study. PATIENT SAMPLE One hundred fourty-six patients. OUTCOME MEASURES Clinical outcome, laboratory indexes and radiological results METHODS This research retrospectively analyzed 146 patients with cervical spinal tuberculosis who were treated by anterior debridement, decompression, bone grafting, and instrumentation in four institutions between January 2000 and January 2015. There were 68 males and 78 females with an average age of 31.32±11.69years. All patients received chemotherapy for 18 months after surgery, and fixed by brace for 3 months. Clinical outcome, laboratory indexes and radiological results were analyzed to evaluate the efficacy of anterior approach surgery in the treatment of cervical spinal tuberculosis. RESULTS All cases were followed up about 18-52 months later (average 24 months). At the last follow-up, all patients obtained bone fusion, pain relief and neurological recovery. There was no recurrence in any of the patients, and no internal fixation related complications. There were statistically significant differences before and after treatment in terms of Visual analog scale (VAS), Neck disability index (NDI) and Japanese Orthopedic Association (JOA) (P CONCLUSIONS One stage anterior-only approach surgery for the treatment of cervical spinal tuberculosis showed excellent efficacy andthe complication rate of anterior approach surgery was 12%., so it is a recommendable surgical method.