Chinese Journal of Tissue Engineering Research ›› 2013, Vol. 17 ›› Issue (22): 4034-4041.doi: 10.3969/j.issn.2095-4344.2013.22.007

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Titanium mesh and interbody fusion repair medium and severe kyphosis deformity

Chu Ge1, Zhang Hong-qi1, Tang Ming-xing1, Guo Chao-feng1, Li Jin-song1, Xiang Ze-wen2,Bai Jing-ping3   

  1. 1 Department of Spine Surgery, Xiangya Hospital of Central South University, Changsha  410008, Hunan Province, China
    2 First Department of Spine Surgery, Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region, Urumqi  830000, Xinjiang Uygur Autonomous Region, China
    3 Department of Orthopedics, Cancer Hospital of Xinjiang Uygur Autonomous Region, Urumqi  830000, Xinjiang Uygur Autonomous Region, China
  • Online:2013-05-28 Published:2013-05-28
  • Contact: Zhang Hong-qi, M.D., Chief physician, Doctoral supervisor, Department of Spine Surgery, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
  • About author:Chu Ge☆, Studying for doctorate, Attending physician, Department of Spine Surgery, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China Xiaochu138@sina.com

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Abstract:

BACKGROUND: Scholars have supposed that the treatment of spinal tuberculosis kyphosis with anterior approach and spinal cord decompression may lead to complications such as bone graft collapse, absorption or fracture. Studies have confirmed that one-stage anterior-posterior surgery combined with internal fixation can enhance the corrective effect to kyphosis, avoid bone graft complications, reduce the formation of false joints, help patients with early activities out of bed and promote the functional recovery.
OBJECTIVE: To evaluate the clinical outcome for tuberculous spondylitis of thoracolumbar region with two or more affected segments treated with one-stage anterior-posterior debridement, interbody fusion and internal fixation.
METHODS: We retrospectively studied 20 cases of tuberculous spondylitis of thoracolumbar region with two or more levels of involvement. All the patients underwent one-stage posterior fixation fusion and anterior debridement and titanium mesh fusion and internal fixation. All the patients received antituberculosis chemotherapy for 9 months after internal fixation. For the first 3 months, the patients were treated with quadruple antituberculosis drugs, and then treated with triple antituberculosis drugs in the later 6 months. The kyphosis angles were measured during follow-up to evaluate the fusion status, neuropathy and functional recovery.
RESULTS AND CONCLUSION: All the patients were followed-up for more than 37 months. All patients returned to their previous occupation after firmly segment fusion; only 15 cases (75%) felt mild pain or no pain and three cases (15%) with major limitations in activities. There were 11 patients with neurological deficit before internal fixation, and nine cases of these achieved complete neurological recovery. The kyphosis angles were corrected for 35.1° (84.8%) in average (P < 0.001), and there was no significant difference in correction loss during the follow-up period (P < 0.05). There were no grafts or fixation-related complications. Tuberculous spondylitis with involvements at two or more levels accompanied by medium and severe kyphosis should be treated with circumferential fusion, that is one-stage anterior-posterior fusion and fixation, which can obtain greater correction, help the patients with early activities out of bed, stabilize the lesioned segments, and long-term maintain the correction effect.

Key words: bone and joint implants, spinal implants, spinal lesions, thoracolumbar, internal fixation, titanium mesh, one-stage anterior-posterior approach, spinal tuberculosis, kyphosis, interbody fusion, neurological function, kyphosis angle, implants

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