Research progress of surgical treatment of thoracolumbar spinal tuberculosis_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GAO Yongjian ¹ ,  OU Yunsheng ² , QUAN Zhengxue ² , JIANG Dianming ¹

1. Department of Orthopedics, the Third Affiliated Hospital of Chongqing Medical University, Chongqing, 401120, P.R.China;
2. Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, P.R.China;

Corresponding author：

OU Yunsheng, Email: ouyunsheng2001@163.com

Keywords：

Spinal tuberculosis; surgical approach; bone graft fusion; internal fixation; bone graft material

DOI：

10.7507/1002-1892.201705124

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To review the progress of surgical treatment for the thoracolumbar spinal tuberculosis. Methods The related literature of surgical treatment for the thoracolumbar spinal tuberculosis was reviewed and analyzed from the aspects such as surgical approach, fixed segments, fusion ranges, bone graft, and bone graft material research progress. Results Most scholars prefer anterior or combined posterior approach for surgical treatment of thoracic and lumbar tuberculosis because it possessed advantage of precise effectiveness. In recent years, a simple posterior surgery achieved satisfactory effectiveness. The fixation segments are mainly composed of short segments or intervertebral fixation. The interbody fusion is better for the bone graft fusion range and manner, and the bone graft materials is most satisfied with autologous iliac Cage or titanium Cage filled with autologous cancellous bone. Conclusion The perfect strategy for treating the thoracolumbar spinal tuberculosis has not yet been developed, and the personalized therapy for different patients warrants further study.

Citation： GAO Yongjian, OU Yunsheng, QUAN Zhengxue, JIANG Dianming. Research progress of surgical treatment of thoracolumbar spinal tuberculosis. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(1): 112-117. doi: 10.7507/1002-1892.201705124 Copy

1.	WHO/Europe. Status paper on prisons and tuberculosis. Prisões, 2007.
2.	Organization WH. Global Tuberculosis Control: WHO Report 2011. Australian & New Zealand Journal of Public Health, 2012, 36(5): 497-498.
3.	Dara M, Kremer K, Huitric E, et al. Tuberculosis surveillance and monitoring in Europe 2012. Stockholm: European Centre for Disease Prevention and Control, 2012.
4.	Tuli SM. Tuberculosis of the spine: a historical review. Clin Orthop Relat Res, 2007, 460: 29-38.
5.	Tuli SM. Historical aspects of Pott’s disease (spinal tuberculosis) management. Eur Spine J, 2013, 22 Suppl 4: 529-538.
6.	Jutte PC, Van Loenhout-Rooyackers JH. Routine surgery in addition to chemotherapy for treating spinal tuberculosis. Cochrane Database Syst Rev, 2006, 25(1): CD004532.
7.	Nene A, Bhojraj S. Results of nonsurgical treatment of thoracic spinal tuberculosis in adult. Spine J, 2005, 5(1): 79-84.
8.	Sai Kiran NA, Vaishya S, Kale SS, et al. Surgical results in patients with tuberculosis of the spine and severe lower-extremity motor deficits: a retrospective study of 48 patients. J Neurosurg Spine, 2007, 6(4): 320-326.
9.	Garg RK, Somvanshi DS. Spinal tuberculosis: a review. J Spinal Cord Med, 2011, 34(5): 440-454.
10.	Zhang H, Zeng K, Yin X, et al. Debridement, internal fixation, and reconstruction using titanium mesh for the surgical treatment of thoracic and lumbar spinal tuberculosis via a posterior-only approach: a 4-year follow-up of 28 patients. J Orthop Surg Res, 2015, 10: 150.
11.	Gao Y, Ou Y, Deng Q, et al. Comparison between titanium mesh and autogenous iliac bone graft to restore vertebral height through posterior approach for the treatment of thoracic and lumbar spinal tuberculosis. PLoS One, 2017, 12(4): e0175567.
12.	许建中. 规范脊柱结核治疗, 为我国结核病防治做出更大贡献. 中华骨科杂志, 2014, 34(2): 97-101.
13.	Yin XH, Zhou ZH, Yu HG, et al. Comparison between the antero-posterior and posterior only approaches for treating thoracolumbar tuberculosis (T₁₀-L₂) with kyphosis in children: a minimum 3-year follow-up. Childs Nerv Syst, 2016, 32(1): 127-133.
14.	Zeng H, Zhang P, Shen X, et al. One-stage posterior-only approach in surgical treatment of single-segment thoracic spinal tuberculosis with neurological deficits in adults: a retrospective study of 34 cases. BMC Musculoskelet Disord, 2015, 16: 186.
15.	Azam MQ, Sadat-Ali M. The Concept of Evolution of Thoracolumbar Fracture Classifications Helps in Surgical Decisions. Asian Spine J, 2015, 9(6): 984-994.
16.	Wang LJ, Zhang HQ, Tang MX, et al. Comparison of Three Surgical Approaches for Thoracic Spinal Tuberculosis in Adult: Minimum 5-Year Follow-Up. Spine (Phila Pa 1976), 2017, 42(11): 808-817.
17.	Yang P, Zang Q, Kang J, et al. Comparison of clinical efficacy and safety among three surgical approaches for the treatment of spinal tuberculosis: a meta-analysis. Eur Spine J, 2016, 25(12): 3862-3874.
18.	Zeng H, Shen X, Luo C, et al. Comparison of three surgical approaches for cervicothoracic spinal tuberculosis: a retrospective case-control study. J Orthop Surg Res, 2015, 10: 100.
19.	Mihir B, Vinod L, Umesh M, et al. Anterior instrumentation of the cervicothoracic vertebrae: approach based on clinical and radiologic criteria. Spine (Phila Pa 1976), 2006, 31(9): E244-249.
20.	张泽华, 陈非凡, 李建华, 等. 不同类型腰骶椎结核手术治疗方式的有效性和安全性研究. 中华骨科杂志, 2016, 36(11): 662-671.
21.	杨寅, 张延平, 贺西京, 等. 一期侧前路双钉棒系统固定治疗腰骶段脊柱结核. 中华骨科杂志, 2016, 36(4): 208-214.
22.	Panchmatia JR, Lenke LG, Molloy S, et al. Review article: Surgical approaches for correction of post-tubercular kyphosis. J Orthop Surg (Hong Kong), 2015, 23(3): 391-394.
23.	Singh K, Vaccaro AR, Kim J, et al. Biomechanical comparison of cervical spine reconstructive techniques after a multilevel corpectomy of the cervical spine. Spine (Phila Pa 1976), 2003, 28(20): 2352-2358.
24.	Pu X, Zhou Q, He Q, et al. A posterior versus anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis. Int Orthop, 2012, 36(2): 307-313.
25.	Zhang HQ, Li JS, Zhao SS, et al. Surgical management for thoracic spinal tuberculosis in the elderly: posterior only versus combined posterior and anterior approaches. Arch Orthop Trauma Surg, 2012, 132(12): 1717-1723.
26.	Jin W, Wang Z. Clinical evaluation of the stability of single-segment short pedicle screw fixation for the reconstruction of lumbar and sacral tuberculosis lesions. Arch Orthop Trauma Surg, 2012, 132(10): 1429-1435.
27.	唐永超, 梁德, 江晓兵, 等. 一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核. 中国修复重建外科杂志, 2013, 27(3): 383-383.
28.	Cantasdemir M, Kara B, Cebi D, et al. Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas. Clin Radiol, 2003, 58(10): 811-815.
29.	Tsagouli P, Sotiropoulou E, Filippousis P. Contribution of computed tomography guided percutaneous drainage of tuberculous cold abscesses adjunctive to pharmaceutical anti-tubercular treatment. Eur J Radiol, 2012, 81(3): 562-565.
30.	Manoharan SR, Leitao J, Emberton P, et al. A large tuberculosis abscess causing spinal cord compression of the cervico-thoracic region in a young child. Eur Spine J, 2013, 22(7): 1459-1463.
31.	Zhang XF, Wang Y, Xiao SH, et al. Treatment of lumbar and lumbosacral spinal tuberculosis with minimally invasive surgery. OrthopSurg, 2010, 2(1): 64-70.
32.	Yang H, Hou K, Zhang L, et al. Minimally invasive surgery through the interlaminar approach in the treatment of spinal tuberculosis: A retrospective study of 31 patients. J Clin Neurosci, 2016, 32: 9-13.
33.	Garg N, Vohra R. Minimally invasive surgical approaches in the management of tuberculosis of the thoracic and lumbar spine. Clin OrthopRelat Res, 2014, 472(6): 1855-1867.
34.	刘立岷, 宋跃明, 龚全, 等. 数字技术支撑胸腔镜下胸椎结核病灶清除植骨内固定的临床研究. 中国修复重建外科杂志, 2014, 28(1): 64-68.
35.	陈荣春, 陈云生, 曾云峰, 等. 腹腔镜辅助下联合侧前方小切口腹膜后入路治疗腰椎结核. 中国修复重建外科杂志, 2014, 28(11): 1364-1367.
36.	施建党, 刘园园, 王骞, 等. 病椎固定治疗胸、腰椎结核的疗效分析. 中华骨科杂志, 2016, 36(11): 681-690.
37.	Virk SS, Niedermeier S, Yu E, et al. Adjacent segment disease. Orthopedics, 2014, 37(8): 547-555.
38.	施建党, 王骞, 王自立. 胸、腰椎结核融合及内固定范围的合理选择. 中华骨科杂志, 2016, 36(11): 745-752.
39.	董健文, 冯丰, 赵卫东, 等. 双节段后路腰椎椎体间融合术单侧椎弓根钉固定的生物力学稳定性. 中华外科杂志, 2011, 49(5): 436-439.
40.	Li M, Du J, Meng H, et al. One-stage surgical management for thoracic tuberculosis by anterior debridement, decompression and autogenous rib grafts, and instrumentation. Spine J, 2011, 11(8): 726-733.
41.	武启军, 王自立, 戈朝晖, 等. 脊柱单节段前中柱切除后不同节段椎弓根螺钉内固定的稳定性测试. 中国脊柱脊髓杂志, 2010, 20(4): 267-271.
42.	胡豇, 王跃, 刘仲前, 等. 胸腰椎结核重度后凸畸形并截瘫的手术治疗. 中国修复重建外科杂志, 2014, 28(9): 1110-1114.
43.	Jin W, Wang Q, Wang Z, et al. Complete debridement for treatment of thoracolumbar spinal tuberculosis: a clinical curative effect observation. Spine J, 2014, 14(6): 964-970.
44.	欧云生, 安洪, 权正学, 等. 前路病灶彻底清除植骨内固定治疗胸腰椎结核. 重庆医科大学学报, 2003, 28(5): 617-619.
45.	金卫东, 王骞, 王自立, 等. 彻底与非彻底病灶清除术治疗脊柱结核的比较. 中华骨科杂志, 2014, 34(2): 196-205.
46.	瞿东滨, 金大地. 正确认识脊柱结核病灶清除术. 中国脊柱脊髓杂志, 2008, 18(8): 565-567.
47.	宋跃明. 如何理解脊柱结核病灶彻底清除? 中国脊柱脊髓杂志, 2010, 20(10): 798.
48.	Zhong WY, Xiong GZ, Wang B, et al. Surgical Management for Thoracic Spinal Tuberculosis Posterior Only versus Anterior Video-Assisted Thoracoscopic Surgery. PLoS One, 2015, 10(3): e0119759.
49.	Hou K, Yang H, Zhang L, et al. Stepwise Therapy for Treating Tuberculosis of the Upper Cervical Spine: A Retrospective Study of 11 Patients. Eur Neurol, 2015, 74(1-2): 100-106.
50.	Gong K, Wang Z, Luo Z. Single-stage posterior debridement and transforaminal lumbar interbody fusion with autogenous bone grafting and posterior instrumentation in the surgical management of lumbar tuberculosis. Arch Orthop Trauma Surg, 2011, 131(2): 217-223.
51.	Gao Z, Wang M, Zhu W, et al. Tuberculosis of ultralong segmental thoracic and lumbar vertebrae treated by posterior fixation and cleaning of the infection center through a cross-window. Spine J, 2015, 15(1): 71-78.
52.	English A I. Tuberculosis. The WHO/IUATLD Global Project on Antituberculosis Drug-Resistance Surveillance. Wkly Epidemiol Rec, 1996, 71(38): 281-285.
53.	Chen ST, Zhao LP, Dong WJ, et al. The Clinical Features and Bacteriological Characterizations of Bone and Joint Tuberculosis in China. Sci Rep, 2015, 5: 11084.
54.	罗卓荆. 脊柱结核为什么要彻底清除病灶? 中国脊柱脊髓杂志, 2010, 20(10): 797-798.
55.	崔旭, 马远征, 陈兴, 等. 脊柱结核术后复治的原因分析和手术治疗策略. 中华骨科杂志, 2017, 37(2): 65-73.
56.	李危石, 陈仲强, 郭昭庆, 等. 椎间植骨融合与横突间植骨融合治疗腰椎滑脱症的比较. 中国脊柱脊髓杂志, 2005, 15(1): 20-23.
57.	Shen X, Liu H, Wang G, et al. Single-stage posterior-only approach treating single-segment thoracic tubercular spondylitis. Int J Clin Exp Pathol, 2015, 8(9): 11051-11059.
58.	Sundararaj GD, Amritanand R, Venkatesh K, et al. The use of titanium mesh cages in the reconstruction of anterior column defects in active spinal infections: can we rest the crest? Asian Spine J, 2011, 5(3): 155-161.
59.	高永建, 欧云生, 邓乾兴, 等. 钛笼与髂骨块植骨修复椎骨缺损治疗胸腰椎结核的疗效比较. 中国矫形外科杂志, 2017, 25(5): 404-409.
60.	施建党, 王自立, 王沛, 等. 同种异体骨与自体骨在颈椎结核植骨融合中的应用比较. 中国修复重建外科杂志, 2011, 25(11): 1290-1293.

1. WHO/Europe. Status paper on prisons and tuberculosis. Prisões, 2007.
2. Organization WH. Global Tuberculosis Control: WHO Report 2011. Australian & New Zealand Journal of Public Health, 2012, 36(5): 497-498.
3. Dara M, Kremer K, Huitric E, et al. Tuberculosis surveillance and monitoring in Europe 2012. Stockholm: European Centre for Disease Prevention and Control, 2012.
4. Tuli SM. Tuberculosis of the spine: a historical review. Clin Orthop Relat Res, 2007, 460: 29-38.
5. Tuli SM. Historical aspects of Pott’s disease (spinal tuberculosis) management. Eur Spine J, 2013, 22 Suppl 4: 529-538.
6. Jutte PC, Van Loenhout-Rooyackers JH. Routine surgery in addition to chemotherapy for treating spinal tuberculosis. Cochrane Database Syst Rev, 2006, 25(1): CD004532.
7. Nene A, Bhojraj S. Results of nonsurgical treatment of thoracic spinal tuberculosis in adult. Spine J, 2005, 5(1): 79-84.
8. Sai Kiran NA, Vaishya S, Kale SS, et al. Surgical results in patients with tuberculosis of the spine and severe lower-extremity motor deficits: a retrospective study of 48 patients. J Neurosurg Spine, 2007, 6(4): 320-326.
9. Garg RK, Somvanshi DS. Spinal tuberculosis: a review. J Spinal Cord Med, 2011, 34(5): 440-454.
10. Zhang H, Zeng K, Yin X, et al. Debridement, internal fixation, and reconstruction using titanium mesh for the surgical treatment of thoracic and lumbar spinal tuberculosis via a posterior-only approach: a 4-year follow-up of 28 patients. J Orthop Surg Res, 2015, 10: 150.
11. Gao Y, Ou Y, Deng Q, et al. Comparison between titanium mesh and autogenous iliac bone graft to restore vertebral height through posterior approach for the treatment of thoracic and lumbar spinal tuberculosis. PLoS One, 2017, 12(4): e0175567.
12. 许建中. 规范脊柱结核治疗, 为我国结核病防治做出更大贡献. 中华骨科杂志, 2014, 34(2): 97-101.
13. Yin XH, Zhou ZH, Yu HG, et al. Comparison between the antero-posterior and posterior only approaches for treating thoracolumbar tuberculosis (T₁₀-L₂) with kyphosis in children: a minimum 3-year follow-up. Childs Nerv Syst, 2016, 32(1): 127-133.
14. Zeng H, Zhang P, Shen X, et al. One-stage posterior-only approach in surgical treatment of single-segment thoracic spinal tuberculosis with neurological deficits in adults: a retrospective study of 34 cases. BMC Musculoskelet Disord, 2015, 16: 186.
15. Azam MQ, Sadat-Ali M. The Concept of Evolution of Thoracolumbar Fracture Classifications Helps in Surgical Decisions. Asian Spine J, 2015, 9(6): 984-994.
16. Wang LJ, Zhang HQ, Tang MX, et al. Comparison of Three Surgical Approaches for Thoracic Spinal Tuberculosis in Adult: Minimum 5-Year Follow-Up. Spine (Phila Pa 1976), 2017, 42(11): 808-817.
17. Yang P, Zang Q, Kang J, et al. Comparison of clinical efficacy and safety among three surgical approaches for the treatment of spinal tuberculosis: a meta-analysis. Eur Spine J, 2016, 25(12): 3862-3874.
18. Zeng H, Shen X, Luo C, et al. Comparison of three surgical approaches for cervicothoracic spinal tuberculosis: a retrospective case-control study. J Orthop Surg Res, 2015, 10: 100.
19. Mihir B, Vinod L, Umesh M, et al. Anterior instrumentation of the cervicothoracic vertebrae: approach based on clinical and radiologic criteria. Spine (Phila Pa 1976), 2006, 31(9): E244-249.
20. 张泽华, 陈非凡, 李建华, 等. 不同类型腰骶椎结核手术治疗方式的有效性和安全性研究. 中华骨科杂志, 2016, 36(11): 662-671.
21. 杨寅, 张延平, 贺西京, 等. 一期侧前路双钉棒系统固定治疗腰骶段脊柱结核. 中华骨科杂志, 2016, 36(4): 208-214.
22. Panchmatia JR, Lenke LG, Molloy S, et al. Review article: Surgical approaches for correction of post-tubercular kyphosis. J Orthop Surg (Hong Kong), 2015, 23(3): 391-394.
23. Singh K, Vaccaro AR, Kim J, et al. Biomechanical comparison of cervical spine reconstructive techniques after a multilevel corpectomy of the cervical spine. Spine (Phila Pa 1976), 2003, 28(20): 2352-2358.
24. Pu X, Zhou Q, He Q, et al. A posterior versus anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis. Int Orthop, 2012, 36(2): 307-313.
25. Zhang HQ, Li JS, Zhao SS, et al. Surgical management for thoracic spinal tuberculosis in the elderly: posterior only versus combined posterior and anterior approaches. Arch Orthop Trauma Surg, 2012, 132(12): 1717-1723.
26. Jin W, Wang Z. Clinical evaluation of the stability of single-segment short pedicle screw fixation for the reconstruction of lumbar and sacral tuberculosis lesions. Arch Orthop Trauma Surg, 2012, 132(10): 1429-1435.
27. 唐永超, 梁德, 江晓兵, 等. 一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核. 中国修复重建外科杂志, 2013, 27(3): 383-383.
28. Cantasdemir M, Kara B, Cebi D, et al. Computed tomography-guided percutaneous catheter drainage of primary and secondary iliopsoas. Clin Radiol, 2003, 58(10): 811-815.
29. Tsagouli P, Sotiropoulou E, Filippousis P. Contribution of computed tomography guided percutaneous drainage of tuberculous cold abscesses adjunctive to pharmaceutical anti-tubercular treatment. Eur J Radiol, 2012, 81(3): 562-565.
30. Manoharan SR, Leitao J, Emberton P, et al. A large tuberculosis abscess causing spinal cord compression of the cervico-thoracic region in a young child. Eur Spine J, 2013, 22(7): 1459-1463.
31. Zhang XF, Wang Y, Xiao SH, et al. Treatment of lumbar and lumbosacral spinal tuberculosis with minimally invasive surgery. OrthopSurg, 2010, 2(1): 64-70.
32. Yang H, Hou K, Zhang L, et al. Minimally invasive surgery through the interlaminar approach in the treatment of spinal tuberculosis: A retrospective study of 31 patients. J Clin Neurosci, 2016, 32: 9-13.
33. Garg N, Vohra R. Minimally invasive surgical approaches in the management of tuberculosis of the thoracic and lumbar spine. Clin OrthopRelat Res, 2014, 472(6): 1855-1867.
34. 刘立岷, 宋跃明, 龚全, 等. 数字技术支撑胸腔镜下胸椎结核病灶清除植骨内固定的临床研究. 中国修复重建外科杂志, 2014, 28(1): 64-68.
35. 陈荣春, 陈云生, 曾云峰, 等. 腹腔镜辅助下联合侧前方小切口腹膜后入路治疗腰椎结核. 中国修复重建外科杂志, 2014, 28(11): 1364-1367.
36. 施建党, 刘园园, 王骞, 等. 病椎固定治疗胸、腰椎结核的疗效分析. 中华骨科杂志, 2016, 36(11): 681-690.
37. Virk SS, Niedermeier S, Yu E, et al. Adjacent segment disease. Orthopedics, 2014, 37(8): 547-555.
38. 施建党, 王骞, 王自立. 胸、腰椎结核融合及内固定范围的合理选择. 中华骨科杂志, 2016, 36(11): 745-752.
39. 董健文, 冯丰, 赵卫东, 等. 双节段后路腰椎椎体间融合术单侧椎弓根钉固定的生物力学稳定性. 中华外科杂志, 2011, 49(5): 436-439.
40. Li M, Du J, Meng H, et al. One-stage surgical management for thoracic tuberculosis by anterior debridement, decompression and autogenous rib grafts, and instrumentation. Spine J, 2011, 11(8): 726-733.
41. 武启军, 王自立, 戈朝晖, 等. 脊柱单节段前中柱切除后不同节段椎弓根螺钉内固定的稳定性测试. 中国脊柱脊髓杂志, 2010, 20(4): 267-271.
42. 胡豇, 王跃, 刘仲前, 等. 胸腰椎结核重度后凸畸形并截瘫的手术治疗. 中国修复重建外科杂志, 2014, 28(9): 1110-1114.
43. Jin W, Wang Q, Wang Z, et al. Complete debridement for treatment of thoracolumbar spinal tuberculosis: a clinical curative effect observation. Spine J, 2014, 14(6): 964-970.
44. 欧云生, 安洪, 权正学, 等. 前路病灶彻底清除植骨内固定治疗胸腰椎结核. 重庆医科大学学报, 2003, 28(5): 617-619.
45. 金卫东, 王骞, 王自立, 等. 彻底与非彻底病灶清除术治疗脊柱结核的比较. 中华骨科杂志, 2014, 34(2): 196-205.
46. 瞿东滨, 金大地. 正确认识脊柱结核病灶清除术. 中国脊柱脊髓杂志, 2008, 18(8): 565-567.
47. 宋跃明. 如何理解脊柱结核病灶彻底清除? 中国脊柱脊髓杂志, 2010, 20(10): 798.
48. Zhong WY, Xiong GZ, Wang B, et al. Surgical Management for Thoracic Spinal Tuberculosis Posterior Only versus Anterior Video-Assisted Thoracoscopic Surgery. PLoS One, 2015, 10(3): e0119759.
49. Hou K, Yang H, Zhang L, et al. Stepwise Therapy for Treating Tuberculosis of the Upper Cervical Spine: A Retrospective Study of 11 Patients. Eur Neurol, 2015, 74(1-2): 100-106.
50. Gong K, Wang Z, Luo Z. Single-stage posterior debridement and transforaminal lumbar interbody fusion with autogenous bone grafting and posterior instrumentation in the surgical management of lumbar tuberculosis. Arch Orthop Trauma Surg, 2011, 131(2): 217-223.
51. Gao Z, Wang M, Zhu W, et al. Tuberculosis of ultralong segmental thoracic and lumbar vertebrae treated by posterior fixation and cleaning of the infection center through a cross-window. Spine J, 2015, 15(1): 71-78.
52. English A I. Tuberculosis. The WHO/IUATLD Global Project on Antituberculosis Drug-Resistance Surveillance. Wkly Epidemiol Rec, 1996, 71(38): 281-285.
53. Chen ST, Zhao LP, Dong WJ, et al. The Clinical Features and Bacteriological Characterizations of Bone and Joint Tuberculosis in China. Sci Rep, 2015, 5: 11084.
54. 罗卓荆. 脊柱结核为什么要彻底清除病灶? 中国脊柱脊髓杂志, 2010, 20(10): 797-798.
55. 崔旭, 马远征, 陈兴, 等. 脊柱结核术后复治的原因分析和手术治疗策略. 中华骨科杂志, 2017, 37(2): 65-73.
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Chinese Journal of Reparative and Reconstructive Surgery

Research progress of surgical treatment of thoracolumbar spinal tuberculosis

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