In the treatment of tuberculosis of the spine evacuation of the contents of the abscess, including the bone sequestra and the sequestrated intervertebral discs, combined with removal of all avascular bone and anterior fusion with a strut graft has, in our hands, given results superior to those obtained by other methods. Although, for the most part, the patients we treated had advanced disease involving many vertebrae, we have obtained our best and most gratifying results in patients with early lesions.
We should like to emphasize the following points:
1. The anterior approach gives a wide access to the disease, which is always more extensive than the roentgenogram would lead one to suppose.
2. The removal of all avascular bone is essential to ensure rapid, sound fusion.
3. Anterior fusion by bone transplantation after a thorough excision of the disease focus is successful in a very high proportion of cases.
4. Anterior fusion by this method has reduced the period of hospitalization from years to months.
5. In agreement with Pott we believe that 'fusion of the bodies of the vertebrae is the thing to be aimed at', for a soundly fused spine is unlikely to be the seat of recurrent tuberculosis.
Copyright 1960 by The Journal of Bone and Joint Surgery, Incorporated