Medical grade calcium sulfate bone for bone defects after removal of spinal tuberculosis is controversial; however, patients undergoing long-term intramuscular injection of streptomycin for anti-tuberculosis show a poor compliance, and local application can overcome these shortcomings.OBJECTIVE:
To study the clinical efficacy and outcome of medical grade calcium sulfate bone incorporated with streptomycin and autogenetic bone graft combined with posterior debridement and instrumentation for thoracolumbar spinal tuberculosis.METHODS:
From March 2008 to June 2012, 18 patients with thoracolumbar spinal tuberculosis were treated with one-stage posterior debridement, medical grade calcium sulfate bone incorporated with streptomycin and autogenetic bone graft and instrumentation on the basis of regular anti-tuberculosis. Incision healing, adverse reactions and the change of clinical symptoms were recorded. Bone fusion and deformity correction were analyzed by the regular X-ray examination.RESULTS AND CONCLUSION:
All the patients acquired satisfactory incision healing without obvious general adverse reactions. Clinical symptoms were differently relived. Kyphosis was corrected to some degree and the correction had no loss. Seventeen patients were cured after the first operation. Tuberculosis recurred in one patient 9 months after the first surgery and was cured after the second anterior surgery. X-ray examination showed that the calcium sulfate bone was clear 1 week after surgery and unclear 3 months after surgery. Bone fusion appeared 6 to 9 months after operation. These findings indicate that the application of medical grade calcium sulfate bone incorporated with streptomycin could achieve good effects in the treatment of thoracolumbar spinal tuberculosis, which is an excellent substitute material for bone graft. It not only could repair bone loss but also increase the concentration of anti-tuberculosis drugs.