Various Methods Effective in Treating Lower Cervical Spine TB

Anterior debridement, decompression, bone grafting, and instrumentation for lower cervical spine tuberculosis were found effective treatment in a recent retrospective study.

Maolin He, M.D., and colleagues evaluated the results of 25 patients with lower cervical spine tuberculosis (TB) who were treated with anterior debridement, decompression, bone grafting, and instrumentation over a five-year period.

“This preliminary study indicates that anterior debridement, decompression, bone grafting, and instrumentation are safe and effective techniques with good clinical and radiologic outcomes for patients with lower cervical TB, especially for those who had disease affecting fewer than three vertebrae,” He and colleagues wrote in the study.

They included 25 patients with lower cervical TB treated with anterior debridement, decompression, bone grafting, and instrumentation at the authors’ institution between June 2005 and June 2010 (18 males, seven females; ages 4 years to 69 years). Three patients had disease involvement one vertebrae, 18 patients had two vertebrae of involvement, and four patients had three vertebrae of involvement, based on data in the study. Prior to surgery three patients were Frankel grade B, five patients were Frankel grade C, 12 patients were Frankel grade D and five patients were Frankel grade E, as noted.

He and colleagues followed up the patients an average of 37.4 months after surgery.

“During the last follow-up examination, in 20 patients with neurological deficit, 11 patients improved one grade, six patients improved two grades, one patient improved three grades, and the neurological status remained unchanged in two patients,” they wrote.

Based on the results, the average kyphotic Cobb angle improved from 15.48 degrees preoperatively to -4. degrees° postoperatively.

Any loss of correction loss during the follow-up was not significant, the investigators noted, adding that solid fusion mass was obtained in all patients.

“TB reactivation was not observed,” He and colleagues wrote.

They reported in the study the method is also useful to promote local bone healing, attain spine stability and prevent late deformity.

“Advantages of this procedure include a single-stage operation as opposed to a combined anterior and posterior procedure, thoroughness of debridement and adequate decompression of the spinal cord, and adequate spinal stabilization,” He and colleagues wrote.