Abstract
Aim
Our aim was to evaluate the feasibility and efficiency of the application of posterior transpedicular debridement with instrumentation and fusion to the treatment of over 60-year-old patients with thoracic tuberculosis.
Methods
Fifteen over 60-year-old patients with thoracic tuberculosis treated by posterior transpedicular debridement with instrumentation and fusion between August 2006 and November 2010, seven males and eight females in this study were reviewed, retrospectively. Their age ranged from 61 to 75 (mean age 63.4). The follow-up period ranged from 12 to 51 months (mean 30 months). The patients were evaluated based on vertebral body loss, kyphotic angle, fusion status of affected segment, visual analog scale (VAS) pain score, and Frankel’s classification.
Results
A solid fusion was achieved in all 15 cases. No postoperative complications, chronic infection, sinus formation or significant loss of deformity correction was noted in these patients. Moreover, VAS score was reduced and Frankel’s grade was recovered in all patients and there was no recurrence of the tuberculous infection.
Conclusions
Posterior transpedicular debridement with instrumentation and fusion is a feasible and effective procedure in the treatment for thoracic tuberculosis in patients over the age of 60.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Rajasekaran S, Shanmugasundaram TK, Prabhakar R et al (1998) Tuberculosis lesions of the lumbosacral region: a 15-year follow-up of patients treated by ambulant chemotherapy. Spine 23:1163–1167
Tuli SM, Srivastava TP, Varma BP et al (1967) Tuberculosis of spine. Acta Orthop Scand 38:445–458
Moon MS, Moon YW, Moon JL et al (2002) Conservative treatment of tuberculosis of the lumbar and lumbosacral spine. Clin Orthop 398:40–49
Mehta JS, Bhojraj SY (2001) Tuberculosis of the thoracic spine. A classification based on the selection of surgical strategies. J Bone Joint Surg Br 83:859–863
Lee SH, Sung JK, Park YM (2006) Single-stage transpedicular decompression and posterior instrumentation in treatment of thoracic and thoracolumbar spinal tuberculosis: a retrospective case series. J Spinal Disord Tech 19:595–602
Lee JS, Moon KP, Kim SJ et al (2007) Posterior lumbar interbody fusion and posterior instrumentation in the surgical management of lumbar tuberculous spondylitis. J Bone Joint Surg Br 89:210–214
Jain AK (2010) Tuberculosis of the spine: a fresh look at an old disease. J Bone Joint Surg Br 92:905–913
Frankel HL, Hancock DO, Hyslop G et al (1969) The value of postural reduction in the initial management of the closed injuries of the spine with paraplegia and tetraplegia. Paraplegia 7:179–192
Moon MS, Woo YK, Lee KS, Ha KY, Kim SS, Sun DH (1976) Posterior instrumentation and anterior interbody fusion for tuberculous kyphosis of dorsal and lumbar spines. Spine 20(17):1910–1916
Moon MS (1997) Tuberculosis of spine: controversies and a new challenges—spine update. Spine 22:1791–1797
Guven O, Kumano K, Talcin S et al (1994) A single stage posterior approach and rigid fixation for preventing kyphosis in the treatment of spinal tuberculosis. Spine 19:1039–1043
Chen WJ, Chen CH, Shih CH (1995) Surgical treatment of tuberculous spondylitis: 50 patients followed for 2–8 years. Acta Orthop Scand 66:137–142
Sundararaj GD (2009) Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach. J Bone Joint Surg Br 91(5):702–703
Jain AK, Dhammi IK, Prashad B, Sinha S, Mishra P et al (2008) Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach. J Bone Joint Surg Br 90(11):1477–1481
Pande KC, Babulkar SS (2002) Atypical spinal tuberculosis. Clin Orthop Relat Res 398:64–74
Wang B, Ozawa H, Tanaka Y et al (2006) One-stage lateral rhachotomy and posterior fusion with compression hooks for the Pott’s paralysis in the elderly. J Orthop Surg 14:310–314
Talu U, Gogus A, Ozturk C et al (2006) The role of posterior instrumentation and fusion after anterior radical debridement and fusion in the surgical treatment of spinal tuberculosis: experience of 127 cases. J Spinal Disord Tech 19:554–559
Lee TC, Lu K, Yang LC et al (1999) Transpedicular instrumentation as an adjunct in the treatment of thoracolumbar and lumbar spine tuberculosis with early stage bone destruction. J Neurosurg 91:163–169
Memtsoudis SG, Vougioukas VI, Ma Y et al (2011) Perioperative morbidity and mortality after anterior, posterior, and anterior/posterior spine fusion surgery. Spine 36:1867–1877
Conflict of interest
None declared.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
He, B., Hu, Z., Hao, J. et al. Posterior transpedicular debridement, decompression and instrumentation for thoracic tuberculosis in patients over the age of 60. Arch Orthop Trauma Surg 132, 1407–1414 (2012). https://doi.org/10.1007/s00402-012-1565-9
Received:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00402-012-1565-9