The outcome of allografts and anterior instrumentation in spinal tuberculosis.

Spinal tuberculosis is the most common form of osteoarticular tuberculosis. Fractures, slippage, and increasing deformity have been reported with the use of autologous rib grafts after anterior spinal decompression. Forty-one patients with neurologic deficits caused by spinal tuberculosis had radical anterior decompression, and the anterior column was reconstructed with fresh-frozen femoral allografts and stabilized with a single-rod screw construct. Antituberculous therapy was administered for 12 months and complete neurologic recovery occurred in 32 patients. The incorporation of allografts commenced between 12 and 18 months. Fusion and remodeling was observed in 33 patients and partial remodeling with fusion was observed in eight patients at a mean followup of 6.4 years. Forty-two percent correction of the kyphosis was achieved and there were no cases of fracture or late sepsis. Fresh-frozen allografts and anterior instrumentation are superior to rib grafts in supporting the anterior spinal column, and although fusion occurred late, the grafts remained stable.