Efficacy Analysis of Anterior Debridement Combined with Autologous Iliac Bone Grafting, Internal Fixation, and Fusion in the Treatment of Lower Cervical Tuberculosis with Kyphotic Deformity: A Single-Center Retrospective Study

Objective To summarize the clinical efficacy of anterior-only debridement of tuberculous lesions combined with autologous iliac bone grafting, internal fixation, and fusion in the treatment of lower cervical tuberculosis with kyphotic deformity. Methods A retrospective analysis was performed on 49 patients with a confirmed diagnosis of lower cervical tuberculosis complicated by kyphotic deformity who underwent surgical treatment at our institution between January 2007 and December 2023. There were 28 males and 21 females, with ages ranging from 10 to 82 years (mean ± standard deviation, 51.5 ± 16.0 years). All 49 patients presented with varying degrees of neck and shoulder pain and tuberculous toxic symptoms. The lesion involved 2 vertebral bodies in 43 cases, 3 vertebral bodies in 5 cases, and 4 vertebral bodies in 1 case. Preoperatively, all patients received four-drug anti-tuberculosis therapy for 2–4 weeks, which resulted in alleviation of tuberculous toxic symptoms. All patients underwent a single-stage anterior debridement of tuberculous lesions combined with autologous iliac bone grafting, fusion, and titanium plate internal fixation. The operation time and intraoperative blood loss were recorded. Postoperatively, anti-tuberculosis therapy was continued for 6–12 months. During follow-up, the following were evaluated preoperatively and at the final follow-up: improvement in clinical symptoms, bone graft fusion, surgical incision healing, improvement in neurological function (assessed using the Frankel grade), levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), local Cobb angle, Visual Analogue Scale (VAS) scores, and complications. Results All 49 patients successfully underwent the surgery. The operative time ranged from 75 to 150 minutes (101.2 ± 17.4 minutes), and intraoperative blood loss was 60–180 mL (97.8 ± 24.9 mL). The follow-up duration was 12–28 months. At the final follow-up, significant improvements were observed in the local kyphotic Cobb angle, VAS scores, Frankel grades, and levels of CRP and ESR compared with the preoperative values (all P < 0.05). During the follow-up period, no loosening, displacement, or breakage of internal fixation occurred, all surgical incisions achieved primary healing, and there was no recurrence or sinus formation. Postoperative clinical symptoms were significantly alleviated, and complete bone graft fusion was achieved in all patients, with a fusion time of 3–6 months. Conclusion Single-stage anterior debridement of tuberculous lesions combined with autologous iliac bone grafting, fusion, and titanium plate internal fixation is effective in treating lower cervical tuberculosis with kyphotic deformity, as it can thoroughly eradicate tuberculous foci, restore cervical spinal physiological curvature, reconstruct cervical stability, and achieve favorable clinical outcomes.