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Surgical treatment of thoracic spinal tuberculosis with adjacent segments lesion via one-stage transpedicular debridement, posterior instrumentation and combined interbody and posterior fusion, a clinical study

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

To investigate the clinical efficacy and feasibility of one-stage surgical treatment for thoracic spinal tuberculosis 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 studied 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, posterior instrumentation and combined interbody and posterior fusion via a posterior-only approach can be an effective and feasible treatment method for thoracic spinal tuberculosis.

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Acknowledgments

This publication was funded in part by the National Natural Science Foundation of China (81171736).

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Correspondence to Xiyang Wang.

Additional information

Communicated by J. Carlson.

S. Valladares and E. Corredoira contributed equally to this work.

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Wu, P., Luo, C., Pang, X. et al. Surgical treatment of thoracic spinal tuberculosis with adjacent segments lesion via one-stage transpedicular debridement, posterior instrumentation and combined interbody and posterior fusion, a clinical study. Arch Orthop Trauma Surg 133, 1341–1350 (2013). https://doi.org/10.1007/s00402-013-1811-9

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  • DOI: https://doi.org/10.1007/s00402-013-1811-9

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