ABSTRACT

Aim:

Hong Kong procedure that consits of radical debridement and strut grafting is the gold standard in the surgical treatment of tuberculosis spondylitis cases that associated with spinal instability, deformity and neural defects. In recent literature about anterior instrumentations, posterior instrumentation is recommended in multipl spinal involvement to protect the fusion area because of inadequate anterior techniques. In this prospective randomised study, we investigated the minimum 5 years results of screw - dual rod anterior instrumentation in 45 patients that had multipl mobile segment involvement.

Method:

Radiologically kyphotic angulation, global kyphosis and clinically SRS-22 scores were determined in preoperatively, postoperatively and at last follow-ups and these datas were compared.

Results:

The mean preoperative kyphosis angle w as decreased from 23.9° ± 12.1° t o 3.2° ± 4.1° postoperatively that shows average 86.0 ± 16.7 % correction rates and it is found statistically significant (p < 0.05). Physiologic thoracic kyphosis angles obtained in all of the patients. 4 or more scores obtained in SRS-22 questionnaire showed satisfactory results at the last followup in all patients, and statistically significant improvements obtained in preoperative pain, mental status, appareance, function and satisfaction from treatment. All patients demonstrated solid fusion mass without early or late local or systemic complications, recurrence and reactivation.

Conclusion:

According to the datas of this study it is thought that satisfactory results can be obtained with long fixation with anterior dual rod- screw system safely and high correction rates with minimal correction loss in tuberculosis spondylitis patients that have two or more segment involvement.