One-stage posterior procedure in treating active thoracic spinal tuberculosis: a retrospective study

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• 作者：P. Wu (1)
  X. Y. Wang (2)
  X. G. Li (1)
  X. J. Shen (3)
  X. Y. Pang (2)
  C. K. Luo (2)
  Z. Q. Xu (2)
  H. Zeng (2)
  P. H. Zhang (2)
  W. Peng (2)
  
  1. Department of emergency ; Xiang-Ya Hospital ; Central-South University ; 87 ; 聽Xiang-Ya Road ; Changsha ; 410008 ; People鈥檚 Republic of China
  2. Department of spine surgery ; Xiang-Ya Hospital ; Central-South University ; 87 ; 聽Xiang-Ya Road ; Changsha ; 410008 ; People鈥檚 Republic of China
  3. Department of spine surgery ; Hunan Provincial People鈥檚 Hospital ; Hunan Normal University ; 61 ; West jiefang Road ; Changsha ; 410005 ; People鈥檚 Republic of China
  
• 关键词：Spinal tuberculosis ; Isolated posterior approach ; Thoracic
• 刊名：European Journal of Trauma and Emergency Surgery
• 出版年：2015
• 出版时间：April 2015
• 年：2015
• 卷：41
• 期：2
• 页码：189-197
• 全文大小：464 KB
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• 刊物主题：Traumatic Surgery; Surgical Orthopedics; Emergency Medicine; Sports Medicine; Intensive / Critical Care Medicine; Surgery;
• 出版者：Springer Berlin Heidelberg
• ISSN：1863-9941

文摘

Purpose To investigate the clinical efficacy and feasibility of surgical treatment for thoracic spinal tuberculosis with neurological deficit by one-stage posterior instrumentation, proper transpedicular debridement, without anterior instrumentation and without anterior or posterior bone graft. Methods A total of 19 cases with thoracic tuberculosis, neurological deficit and bone destruction (without severe kyphosis) admitted to the hospital from May 2005 to January 2010 were treated by internal fixation, transpedicular debridement without bone graft via the isolated posterior approach. Operating time, blood loss, complications, neurological function, deformity correction, pain relief, and inter-body fusion were investigated. Results The average mean operating time was 168.9聽卤聽21.1聽min. The average blood loss during operation was 655.8聽卤聽82.8聽ml. All patients were followed for 28鈥?6聽months post-operation (average, 36.8聽卤聽5.8聽months). All patients had significant postoperative improvement in ASIA classification scores and VAS scores. The thoracic kyphotic angle was significantly decreased to 11.6掳鈥?0.2掳 after operation (average, 15.6掳聽卤聽2.2掳), and the angle was 12.3掳鈥?1.6掳 (average, 16.4掳聽卤聽2.2掳) at final follow-up. No severe complications or spinal cord injury occurred. The erythrocyte sedimentation rate and C-reactive protein recovered to normal within 3聽months after operation in all patients. All patients have got spontaneous bony fusion within 6鈥?聽months after surgery. Conclusions One-stage posterior instrumentation, transpedicular debridement without bone graft can be an effective and feasible treatment method for selected thoracic spinal tuberculosis.