Abstract:

OBJECTIVE: To explore the clinical effect of anterior or posterior internal fixation following focus debridement on thoracolumbar tuberculosis.
METHODS: A computer-based online search was performed with the key words “thoracolumbar spinal tuberculosis; internal fixation; titanium mesh; autogenous bone; cement; anterior and posterior” in Chinese and English, respectively for articles published from January 2007 to May 2010. Meta analysis or repetitive studies were excluded. A total of 30 articles were included to discuss the clinical outcomes of different implant internal fixations for thoracolumbar tuberculosis.
RESULTS: Titanium alloy as internal fixation materials plus anterior or posterior bone grafting fusion has become main method for treating thoracolumbar tuberculosis. It has advantages that titanium alloy has histocompatibility and corrosivity resistance. Pyrenomycetes formed poloysaccharide on metal surface is relatively few and antituberculosis drugs and patient autoimmunity are effective, therefore, implant-induced infection rate is low. However, long-term implantation of implants for internal fixation stimulates blood vessels and induces fixtor loosening or shedding.
CONCLUSION: With developing internal fixation materials, increasing clinical applications have demonstrated the safety and efficacy of internal fixation in spinal tuberculosis patients. Moreover, reconstruction of spinal stability is important to improve operation efficacy. Internal fixator with low wearing but high compatibility can significantly improve treatment and prolong prosthesis lifespan.