Background: It is not uncommon that some patients in poor general condition and advanced spinal tuberculosis cannot proceed with the staged anterior spinal surgery after posterior instrumentation. We demonstrated a group of patients with advanced spinal tuberculosis that were treated posterior procedure alone.
Methods: From January 1993 to January 2001, 12 patients in our hospital in poor general condition and advanced spinal tuberculosis-marked abscess with angular deformity more than 25 degrees and/or spinal canal compromised more than 30%, were treated in our hospital with posterior instrumentation and chemotherapy only. All patients were immobilized postoperatively with orthosis until solid fusion was noted on bony graft. The chemotherapy persisted for at least 12 months in all patients.
Results: Spontaneous bony fusion of vertebrae at 1-year follow-up averaged 75%. Solid union on posterior or posterolateral fusion was about 91.7%. Implant loosening and deep wound infection were noted in 2 of the patients respectively. We assessed the functional results with the postoperative activity condition, symptom relief and medication dependence in the 6th month after the spinal surgery. Seven cases of the 12 patients (58.3%) had good to excellent results in this series.
Conclusions: The one-stage posterior surgery adjunct with chemotherapy is a considerable and alternative treatment for patients with advanced spinal tuberculosis and in poor general condition.