Abstract: [
Abstract ] Objective Toinvestigatetheclinicefficacyandfeasibilityoftreatingthoracic
tuberculosiscomplicated with nerveinjury byanteriorthorough debridementof Ⅰperiod ,
decompressionofthespinalcanalandbonegraftingandinternalfixation.Methods Thesurgery
ofdebridementofⅠperiod , decompressionofthespinalcanalandbonegraftingandinternal
fixationwerecarriedouton157 patients.Thepatients wereapplied withanti-tuberculosis
treatmentstrengthenedfor3-4weeksregularlybeforesurgery , andthenperformedanoperation
untiltheyhadnosurgicalcontraindications.Theywouldbecontinuousreceivedintensiveanti-
tuberculosistreatmentfor12-18 monthspostoperative.Thesituationsoflesionshealing ,
neurologicalfunctionrecovery , aswellastheimprovementandlossofthekyphosisdeformity
wereevaluated.Results Patientsweresuccessfullyoperated , theaverageoperationtimewas (
5. 2±0.5 ) handtheaveragebleedingamountwas ( 800±150 ) ml.Therewere2casesforpleural
injury , 13casesforintercostalnervepain
, and1caseforcerebrospinalfluidleakage.One
hundredandfifty-sevencaseswerefollowedupfor147cases , andthefollow-upratewas93.6%.
Theaveragefollow-upwas36months , from3monthsto36months.Thesurgicalincisionswere
healingin136cases , infectivein7casesbuthealingbysecondintentionthroughtherapywith
antibioticsanddressing.Onecasedevelopedfistulas , butwashealedafterdressingfor5months.
Primarylesionsoftuberculosiswererecurrencein3cases , andthepatientswereperformedlesion
removalsurgeryandrevisiontwice.Foroneyearsafterthehealingofbonemetastases , 76casesof
patientswerewithgradeIbonehealing , GradeⅡ boneunionwasobtainedin40cases.Ⅲgrade
bonehealingwasobtainedin24cases.Ⅳgradebonehealingwasobtainedin5cases.Incomplete
fusionofgraftboneandinternalfixationfracturewereoccurredin2cases.Theywerefollowedto
receiverevisionsurgery , and5d-2monthslaternervesbegantorecover.Lastfollow-upCobb
angleandVASscoreswerelowerthanpreoperative1d.ASIAgradecomparedwithpreoperative
1daywasobviouslyimproved.Thedifferencewasstatisticallysignificant ( P <0.05 ) .Conclusion
Onthebasisoftheeffectiveanti-tuberculosistreatment , theimplementationofphaseⅠ by
anteriorradicaldebridementanddecompressionandinternalfixationfortreatmentofthoracic
vertebraetuberculosiscomplicatedwithnerveinjurywerebeneficialtotherecoveryofneural
function , kyphosiscorrection , restorethebiomechanicalstabilityofthespine.Itcanbeusedas
aneffectivechoiceforpatientswiththoracictuberculosiswithnerveinjury.

Key words: tuberculosis, spinal , peripheralnerveinjuries , decompression, surgical