Retrospective Evaluation of Combined Anterior and Posterior Surgery with Autologous Tricortical Iliac and Rib Bone Grafting for Severe Kyphotic Deformity in Thoracic Spinal Tuberculosis.

Abstract

Background: Spinal tuberculosis is a common cause of spinal deformity and neurological dysfunction, with surgical treatment being crucial in severe cases. This study evaluates the efficacy and safety of combined anterior and posterior surgery with autologous tricortical iliac bone and rib grafting for treating spinal tuberculosis.

Methods: We included 61 patients with thoracic tuberculosis, who underwent a surgical procedure involving initial posterior correction, followed by anterior debridement and reconstruction with autologous tricortical iliac bone and rib grafts. The surgical outcomes were assessed using preoperative and final follow-up visual analogy scale(VAS) scores, kyphotic Cobb angle, ASIA scores, and radiographic evaluations. Perioperative complications were recorded.

Results: Preoperative VAS scores were 6.65 ± 1.06, significantly decreasing to 2.63 ± 0.94 at the final follow-up (P < 0.001). The kyphotic Cobb angle improved from 26.28°±4.45°preoperatively to 12.05°±2.02°at the final follow-up (P < 0.001). Neurological function improved, with ASIA grade E increasing from 56 patients preoperatively to 59 at follow-up, and all patients achieved bony fusion at the final follow-up. The incidence of perioperative complications was 13.11%, primarily including deep vein thrombosis, superficial wound infections, and urinary tract infections, all of which resolved with symptomatic treatment.

Conclusions: Combined anterior and posterior surgery with autologous tricortical iliac bone and rib grafting is an effective method for treating spinal tuberculosis, significantly alleviating pain, correcting deformity, improving neurological function, and promoting bony fusion.