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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

One-stage posterior-only approach in surgical treatment of single-segment thoracic spinal tuberculosis with neurological deficits in adults: a retrospective study of 34 cases

Zeitschrift:
BMC Musculoskeletal Disorders > Ausgabe 1/2015
Autoren:
Hao Zeng, Penghui Zhang, Xiongjie Shen, Chengke Luo, Zhengquan Xu, Yupeng Zhang, Zheng Liu, Xiyang Wang
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

HZ participated in the design of this study and performed the statistical analysis. HZ drafted the manuscript. XW, XS and ZX carried out the study, together with CL collected important background information. YZ and ZL collect clinical data and follow-up details of this study, and XS participated in the design and helped to draft the manuscript. All authors read and approved the final manuscript.

Abstract

Background

There are quite a few controversies on the surgical management of single-segment thoracic spinal tuberculosis with neurological deficits (STSTND). In this study, the clinical efficacy and feasibility of one-stage posterior-only transpedicular debridement, interbody fusion, and posterior instrumentation for treating STSTND in adults were retrospectively evaluated.

Methods

Thirty-four cases with STSTND underwent one-stage posterior-only transpedicular debridement, interbody fusion and posterior instrumentation at the same institution from January 2003 to January 2013. Follow-up time was 34.4 ± 10.2 months (range, 18–48 months), and kyphosis angle was 34.1 ± 12.3°. The American Spinal Injury Association (ASIA) classification of spinal cord injury was employed to evaluate neurological deficits, while visual analogue scale (VAS) was employed to assess the degree of pain. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were used to evaluate the activity of tuberculosis (TB).

Results

All 34 patients with spinal tuberculosis (ST) were completely cured, and there was no recurrence of TB. Postoperative kyphosis angle was 8.2 ± 1.8°, and there was no significant loss of correction during the final follow-up. Solid fusion was achieved and pain was relieved in all cases. Neurological condition in all patients improved after surgery.

Conclusions

One-stage posterior-only transpedicular debridement, interbody fusion, and posterior fixation followed by chemotherapy seems to be adequate for obtaining satisfactory healing of single-segment thoracic spinal tuberculosis with neurological deficits. Careful patient selection is critical to the successful outcome with this technique.
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