The purpose of this study was to determine the efficacy of stage I posterior
osteotomy and instrumentation followed by stage II anterior
debridement and
bone grafting in patients with lumbar
spinal tuberculosis (TB) with severe
kyphosis. The records of patients with lumbar spinal TB and severe
kyphosis treated with 2-stage surgery at our hospital from 2005 to 2010 were retrospectively reviewed. Outcome measures were
kyphosis correction rate, visual analogue scale (VAS)
pain scores, and American
Spinal Injury Association (ASIA)
spinal cord injury and sensation function scores. A total of 53 patients (34 male, 19 female; mean age 32 years) were included. The number of involved
kyphosis segments ranged from 7 to 14, and the average preoperative
kyphosis angle was 107.3 ± 18.1°. All procedures were performed without serious complications. The average follow-up time was 42 months. Bone fusion occurred at a range of 6 to 9 months after surgery, and none of the patients had internal fixation failure, position change, or
pseudoarthrosis. The mean postoperative
kyphosis angle was 29.4 ± 12.4°, with a mean improvement of 77.9°, and the correction rate was 72.6% (P < 0.001). At final follow-up, average correction loss was 1.35°. The mean postoperative VAS
pain score was 2.4 ± 0.8, and the change from the preoperative value was significant (P < 0.001). ASIA
spinal injury scores were increased postoperatively. Stage I posterior
osteotomy and instrumentation followed by stage II anterior
debridement and
bone grafting can achieve good results in patients with lumbar TB and severe
kyphosis.