Abstract:

Objective     To study the surgical effect of autologous bone graft vs. bone-filled titanium mesh cage graft in the treatment of short-segment lumbar spinal tuberculosis. Method    Forty-two cases of lumbar spinal tuberculosis were treated between January 2006 to and September 2009.  23 of them were given an autologous bone graft plus a simple screw-rod fixation (group A) and the other 19 were treated with bone-filled titanium mesh graft plus a screw-rod fixation (group B). All the patients were subjected to 2-week pre-surgery intensive antituberculosis medication , and this continued on a regular basis for 1 year post-surgery. After 6 weeks of being constrained to bed following the surgery, all the patients were gradually able to get up with the support of a waist protector.  Result     No recurrence happened during the follow-up period of 6 months to 3 years (average 2 years). All the incisions acquired satisfactory primary healing. A significant improvement for the JOA score was noted after surgery in both groups(P＜0.001), while the difference between the two groups was not significant(P＞0.05). Further, the two groups did not exhibit much difference in the improvement of clinical symptoms, recovery of neurological function, surgery-reduced angles, bone fusion, and Cobb angles loss during the long-term follow-up. Neither internal fixation loosening nor obvious titanium mesh cage shifting and nor subsidence were noticed. Conclusion     For short segment (1 or 2) lumbar spinal tuberculosis, treatments with bone graft and titanium mesh cage graft achieved similar and satisfactory results.

Key words: Spinal tuberculosis； Autogenous bone transplantation； Titanium mesh cage； Internal fixations