One-stage surgical treatment for upper thoracic spinal tuberculosis by internal fixation, debridement, and combined interbody and posterior fusion via posterior-only approach

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• 作者：Hongqi Zhang (1)
  Bin Sheng (1)
  Mingxing Tang (1)
  Chaofeng Guo (1)
  Shaohua Liu (1)
  Shu Huang (1)
  Qile Gao (1)
  Jinyang Liu (1)
  Jianhuang Wu (1)
  
• 关键词：Upper thoracic vertebrae ; Spinal tuberculosis ; Bone graft ; Internal fixation ; Posterior
• 刊名：European Spine Journal
• 出版年：2013
• 出版时间：March 2013
• 年：2013
• 卷：22
• 期：3
• 页码：616-623
• 全文大小：378KB
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• 作者单位：Hongqi Zhang (1)
  Bin Sheng (1)
  Mingxing Tang (1)
  Chaofeng Guo (1)
  Shaohua Liu (1)
  Shu Huang (1)
  Qile Gao (1)
  Jinyang Liu (1)
  Jianhuang Wu (1)
  
  1. Department of Spine Surgery, Xiangya Hospital of Central-South University, Changsha, 410008, Hunan, China
  
• ISSN：1432-0932

文摘

Purpose To investigate the clinical efficacy and feasibility of one-stage surgical treatment for upper thoracic spinal tuberculosis by internal fixation, debridement, and combined interbody and posterior fusion via a posterior-only approach. Methods Fourteen patients (eight males, six females) with upper thoracic tuberculosis whose lesions were confined to two adjacent segments were admitted to our hospital. Their ages ranged from 23 to 72?years (average, 50?years). The American Spinal Injury Association (ASIA) impairment scale was used to assess neurological function. ASIA classification showed that preoperatively, one patient was grade A, two patients were grade B, eight patients were grade C, and three patients were grade D. All patients were treated with one-stage surgical treatment by internal fixation, debridement, and combined interbody and posterior fusion via a posterior-only approach. Patients were evaluated preoperatively and postoperatively by measurement of thoracic kyphotic angles using Cobb angle evaluation, determination of erythrocyte sedimentation rate (ESR), evaluation of ASIA impairment scale, and radiological examination. Results Operation time ranged from 70 to 135?min, (average, 110?min). Intraoperative blood loss ranged from 200 to 950?mL (average, 450?mL). All patients were followed up for 22 to 48?months postoperatively (average, 31.5?months). No sinus tract formation, cerebrospinal meningitis, or recurrence of tuberculosis occurred. All patients had significant postoperative improvement in ASIA classification scores. The thoracic kyphotic angles were significantly decreased to 12°-6° postoperatively, and at final follow-up were 13°-8°. The ESR recovered to normal within 6?months postoperatively in all patients. Bone fusion was achieved within 3-?months (average, 5.5?months). Conclusions One-stage surgical treatment for upper thoracic spinal tuberculosis by internal fixation, debridement, and combined interbody and posterior fusion via a posterior-only approach can be an effective and feasible treatment method.