Efficiency of one-stage posterior median incision via costotransverse joint in treating thoracic spinal tuberculosis

Abstract

Objective To assess the efficacy of one-stage posterior median incision via costotransverse joint in treating thoracic spinal tuberculosis. Methods Thirty three patients with tuberculosis of thoracic spine undergoing one-stage posterior thoracic spine debridement, bone grafting fusion and posterior instrumentation from July 2011 to October 2013 were included in the study.There were 18 males and 15 females. The age was from 17 to 39 years old with an average of 29.5. The course was from 5 to 11 months with an average of 7.3. The Cobb angle was from 19° to 42° with an average of 29.8°. There were 5 in upper thoracic spine, 17 in middle thoracic spine and 11 in lower thoracic spine. 6 were in Frankel scale grade C, 11 were in grade D and 16 were in grade E before surgery. Postoperative kyphosis correction, recovery of neurological function and bone fusion were observed. Results All the surgeries were completed successfully. The operation time was from 120 to 230 min with an average of 183. The blood loss during operation was from 480 to 700 ml with an average of 530. All 33 patients were followed-up for 12-36 months with an average of 22.7 months. The Cobb angle was from 8° to 15° with an average of 10.2°, the correction rate was 77%. The Frankel scale of 11 patients recovered from D to E, 2 recovered from C to D and 4 recovered from C to E. The postoperative kyphosis correction and Frankel scale were significantly improved, all patients had a 100% bone fusion rate and there were no internal fixation loosened or shift of graft bone at the last follow-up. ESR and CRP were returned to the normal range and the tuberculosis symptoms disappeared. Conclusions One-stage posterior median incision via costotransverse joint can complete surgery by the same position and the same incision in treating thoracic spinal tuberculosis with safety and good clinical efficacy. Key words: Tuberculosis, osteoarticular; Thoracic vertebrae; Curettage; Treatment outcome; Posterior median incision