Lateral approach bone grafting with internal fixation combined with Gulao Decoction for the treatment of thoracic spinal tuberculosis

Background Thoracic spinal tuberculosis is damaging in nature and may cause neurological deficit. Surgical debridement and stabilization can help. The aim of this study was to observe the clinical efficacy of lateral surgery combined with internal fixation and the effect of Gulao Decoction on postoperative recovery. Methods A retrospective analysis was conducted on 24 patients with thoracic spinal tuberculosis who underwent lateral approach debridement, autologous iliac bone grafting, and single screw-rod internal fixation between August 2017 and September 2019. Patients were grouped based on whether they received adjunctive treatment with Gulao Decoction. Clinical and functional parameters were assessed prior to the operation and at 3 and 18 months post-operation. These parameters included the Visual Analog Scale (VAS) for pain, the Barthel Index for functional independence, the American Spinal Injury Association (ASIA) grade, the Cobb angle, and inflammatory markers such as the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Results At 18 months post-treatment, the overall cure rate was 100%. Patients who received Gulao Decoction in combination with surgery exhibited more significant improvements in VAS scores (from 6.6 ± 0.9 to 1.3 ± 0.7), Cobb angle correction (from 21.3 ± 4.1° to 10.4 ± 2.0°), and Barthel Index (from 52.9 ± 8.8 to 95.0) compared to those who underwent surgery alone ( P < 0.05). Among 10 patients with preoperative neurological deficits, 8 improved from ASIA grade D to E, and 2 from grades B/C to D. ESR and CRP levels returned to normal ranges in all patients. The adjunctive use of Gulao Decoction was associated with enhanced anti-inflammatory response and accelerated functional recovery. All changes were statistically significant. Conclusion The present findings provided reliable and effective treatment for thoracic spinal tuberculosis. Gulao Decoction promoted immune homeostasis, reduced inflammation, thereby enhancing clinical outcomes further.