Long-term outcomes of one-stage anterior debridement, bone grafting, and internal fixation for the treatment of lower cervical tuberculosis with kyphosis

Abstract

Background. Patients with spinal deformities and nerve compression due to spinal tuberculosis often require surgical intervention. The objective of this study was to assess the long-term therapeutic effectiveness of one-stage anterior debridement, bone grafting, and internal fixation for lower cervical tuberculosis with kyphosis. Methods. Twenty-one patients with lower cervical tuberculosis and cervical kyphosis received one-stage anterior debridement, autologous iliac bone grafting, and internal plate fixation. Patients were followed-up postoperatively for at least 5 years. Outcome measures included neck pain using Visual Analogue Scale (VAS) scores, Frankel classification of spinal cord injury, and Cobb angle of cervical kyphosis. Results. Eighteen patients had lesions in 2 vertebrae and 3 had lesions in 3 vertebrae. Cervical tuberculosis was cured in all patients. The mean preoperative VAS score for neck pain was 8 (range: 6–10), whereas the mean best postoperative VAS score was 0.6 (range: 0–3). Mean final VAS score was significantly higher than the best VAS score (2.14 vs. 0.62). Of the 13 patients with symptoms of spinal cord compression, 9 improved by 1 grade and 4 improved by 2 grades according to Frankel classification at final follow-up. The mean preoperative Cobb angle of cervical kyphosis was 29° (range: 15°–50°), whereas the mean postoperative Cobb angle at final follow-up was −1.8° (range: 2–7°). Conclusions. One-stage anterior debridement, bone grafting, and internal fixation can effectively remove lesions, decompress the nerve, reduce pain, and correct kyphosis in patients with cervical tuberculosis and associated kyphosis. Long-term postoperative outcomes were satisfactory.

Keywords::

• deformity
• instrumentation
• lower cervical kyphosis
• tuberculosis

Declaration of interest: The authors report no declarations of interest. The authors are alone responsible for the content and writing of the article.