Surgical treatment of thoracic spinal tuberculosis with adjacent segments lesion via one-stage trans

• 作 者: Ping Wu Chenke Luo Xiaoyang Pang Zhengquan Xu Hao Zeng Xiyang Wang
• 机 构: Department of Spine Surgery, Xiang-Ya Hospital,Central-South University, 87, Xiang-Ya Road, Changsha
• 出 处: 第三届全国脊柱结核诊疗新技术研讨会暨2017年湖南省医学会脊柱外科专业委员会年会
• 发表日期: 2017年8期
• 关键词: Spinal tuberculosis Posterior approach only Thoracic Fusion

　　Purpose To investigate the clinical efficacy and feasibil-ity of one-stage surgical treatment for thoracic spinal tuber-culosis with adjacent segments lesion by internal fixation,transpedicular debridement,and combined interbody and posterior fusion via a posterior-only approach.Materials and methods Twenty-one patients (thirteen males,eight females) with thoracic tuberculosis whose lesions were confined to two adjacent segments were stud-ied retrospectively.All patients were treated with one-stage surgical treatment by internal fixation,transpedicular debridement,and combined interbody and posterior fusion via a posterior-only approach.The American Spinal Injury Association (ASIA) impairment scale was used to assess neurological function.Thoracic Cobb angle was used to assess thoracic kyphosis.Operating time,blood loss,complications,neurological function,deformity correction and interbody fusion were investigated.Results Average mean operating time was 231.4 ± 31.9 min,and evaluated blood loss during operation was 880.2 ± 112.7 ml.All patients were followed up for 22-41 months postoperatively (average 29.8 ± 5.4 months).All patients had significant postoperative improvement in ASIA classification scores.The thoracic kyphotic angles were significantly decreased to 9°-25° postoperatively (average 16.7° ± 4.4°),and at final follow-up were 10°-27°(average 17.7° ± 4.4°).No severe complications or spinal cord injury occurred.The erythrocyte sedimentation rate recovered to normal within 3 months postoperatively in all patients.All patients got bony fusion within 6-9 months after surgery.Conclusions One-stage transpedicular debridement,poste-rior instrumentation and combined interbody and posterior fusion via a posterior-only approach can be an effective and feasible treatment method for thoracic spinal tuberculosis.