Clinical research of thoracoscopy-assisted mini-open surgery for anterior column reconstruction of thoracic spine tuberculosis

Abstract

To evaluate the clinic effects of thoracoscopy-assisted mini-open surgery for anterior column reconstruction of thoracic spine tuberculosis. Sixty patients with thoracic spine tuberculosis, involving segments T4 to T12, with a kyphotic angle of 29.2 degrees (18-42 degrees), 38 males and 22 females, aged 47.4 (19-68), with large paraspinal abscess in 50 cases, pleurisy in 17, and dural compression in 42 cases shown by imaging examination, underwent thoracoscopic-assisted mini-open surgery, including radical debridement and anterior spinal reconstruction. According to Frankel's grade, the preoperative neurological function was judged as: Grade A in 1 case, Grade B in 4, Grade C in 6, Grade D in 19, and Grade E in 30. The patients were followed up for 3.6 years. The outcomes were evaluated retrospectively. The operation was accomplished successfully in all 60 patients. The average operative time was 230 min (180-320 min), the average blood loss during operation was 570 ml (350-1200 ml), the mean drainage duration was 3.6 d (3-5 d). Complications occurred in 18 patients (30%). 30 patients showed neurological improvement from 1 to 3 Grades at the last follow-up. The average correction rate of kyphotic angle was 36.6%, and no obvious correction loss was detected during the follow-up. No patient showed recurrence of tuberculosis. Thoracoscopy-assisted mini-open surgery provides a simple, safe, effective, and practical technology with minimal invasiveness for the treatment of thoracic spine tuberculosis.