Objective: To discuss the failure reasons of operation for spinal tuberculosis complicated with paraplegia and methods of the second operation.
Methods: Spinal tuberculosis paraplegic patients (18 males, 14 females) were reviewed retrospectively. They have been treated with failing decompressive surgery from January 2001 to December 2006. Seventeen patients received anterior debridement surgery via transpleural approach while the other 15 patients received posterolateral decompression surgery via costotransverse approach. Twenty-two patients got chemotherapy after the surgery.
Results: Twenty-three patients were treated by anterior debridement, decompression and graft placement via transpleural approach (9 received the single-stage posterior instrumentation). Five patients received posterolateral debridement and decompression via extrapleural approach. Two patients, recur focus be eliminated. Two patients were given sinus debridement surgery alone. All patients were given anti-tuberculosis chemotherapy. The paraplegia was recovered completely in 26 patients, and partly in 5 patients.
Conclusions: Inadequate treatment results in defeated operative. The proper selection of operative modalities and timing on the basis of systematically anti-tuberculosis chemotherapy remains the best mode of therapy for spinal tuberculosis complicated with paraplegia. And it is also essential to choose a radical debridement surgery to decompress the spinal cord and to reconstruct the stability of spine.