The anterior-only approach could not provide strong fixation whereas the posterior surgery could not clear up the lesions completely. The method combining anterior and posterior approaches to treat the atlantoaxial tuberculosis is advisable.
To evaluate the effectiveness of anterior transoral debridement combined with posterior fixation and fusion for atlantoaxial tuberculosis.
The clinical data of 20 patients with atlantoaxial tuberculosis who underwent the surgery of anterior transoral debridement combined with posterior fixation and fusion in our hospital were retrospectively analyzed. Antituberculosis drugs were administered for 18 months after surgery. Neurological status, clinical symptoms, fusion, reduction, and complications were all evaluated.
Surgeries for 20 cases were performed successfully with no injury of spinal cord, nerve and blood vessel. Clinical symptomatic relief was presented on 20 patients (100%). The improvement of postoperative Japanese Orthopaedic Association score, occipitocervical visual analog scale and atlanto-dental interval were significant (P<0.05). The average follow-up duration was 33 months (range 24-48 months). Bony fusion was achieved in all 20 cases. No serious complications were documented during follow-up.
Anterior transoral debridement combined with posterior fixation and fusion is an effective treatment for atlantoaxial tuberculosis, which plays an important role in removing the lesions and restoring stability.

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