Anterior Debridement, Bone Grafting And Fixation For Cervical Spine Tuberculosis :Iliac Bone Graft Versus Structural Manubrium Graft

Background: The purpose of this retrospective study was to compare the clinical outcomes of anterior surgical management for cervical spinal tuberculosis by iliac bone grafts versus structural manubrium graft. Methods: From January 2009 to September 2018, 23 patients with cervical spinal tuberculosis were treated with anterior debridement,autogenous structural bone graft and fixation at our spinal department. The patients were divided into 2 groups according to the different graft material,including iliac crest bone grafts in group A, structural manubrium grafts in group B. The clinical and radiographic results for the 2 groups were analyzed and compared. Results: The mean duration of follow-up was 24 months. Bony fusion was achieved in all cases without failure of internal fixation. There were no significant differences between groups regarding the the operation time,blood loss,fusion time,neurological outcomes,and postoperative local Cobb angle (P>.05).However,the donor site complication rate of Group A was more than that of Group B. Postoperative ambulation time in group A was later than that of group B.The mean visual analog scale (VAS) for donor-site pain in group A was higher than group B at a week after surgery (P .05). Conclusion: Both iliac bone grafts and sternal manubrium grafts can effectively reconstruct anterior column defects in anterior surgery. However,structural sternal manubrium autografts has less complications associated with donor site morbidities than that of iliac bone.