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

Abstract

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. 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. Average mean operating time was 231.4±31.9min, and evaluated blood loss during operation was 880.2±112.7ml. All patients were followed up for 22-41months postoperatively (average 29.8±5.4months). 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 3months postoperatively in all patients. All patients got bony fusion within 6-9months after surgery. 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.