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Posterior limited unilateral fenestration approach for treating patients with single-segment thoracic and lumbar tuberculosis

  • Original Article - Neurosurgical technique evaluation
  • Published:
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Abstract

Background

Posterior limited unilateral fenestration approach is extensively used in the treatment of many spinal diseases. But whether it is suitable for spinal tuberculosis (TB) is rarely reported. Hence, the current study evaluated the feasibility and efficacy of the posterior limited unilateral fenestration (PLUF) debridement, bone grafting fusion, and instrumentation to treat single-segment thoracic and lumbar TB.

Methods

Eighty-three patients (45 male and 38 female) aged 17–79 years old with the single-segment thoracic and lumbar TB who underwent PLUF debridement, bone grafting fusion, and instrumentation from our hospital were recruited for this study. The operation time, blood loss volume, postoperative complication rate, kyphotic Cobb angle, neurological functional improvement defined by the American Spinal Injury Association (ASIA) classification, the visual analogue scale (VAS) score, and the bone fusion time were utilized for assessing the clinical feasibility and efficacy.

Results

The average follow-up time was 46.9 ± 13.1 (24–72) months. At the last follow-up, the mean kyphotic Cobb angle was significantly reduced from preoperative 23.0° ± 15.3° to postoperative 8.3° ± 11.0° (p < 0.001). Based on the ASIA classification, 89.2% (33 out of 37) patients with preoperative neurological impairment indicated good neurological improvement after the surgery. The VAS pain score significantly decreased from preoperative 6.9 ± 1.1 to 1.3 ± 0.7 3 months after operation (p < 0.001). All the patients achieved solid bony fusion within 13 months of surgery.

Conclusions

For patients with single-segment thoracic and lumbar TB, PLUF debridement, bone grafting fusion, and instrumentation are a feasible and effective surgical treatment.

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Acknowledgements

The authors would like to thank the National Natural Science Foundation of China and the Science Foundation of Xiangya Hospital for Young Scholar.

Funding

This work was supported by the National Natural Science Foundation of China (Grant NO. 82030071) and the Science Foundation of Xiangya Hospital for Young Scholar (Grant No. 2021Q18).

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Authors and Affiliations

  1. Department of Spine Surgery and Orthopaedics, Xiangya Hospital, Central South University, Changsha, China

    Xiaolong Sheng, Zhu Guo, Zhansheng Deng, Liyuan Jiang & Jianzhong Hu

  2. Key Laboratory of Organ Injury, Aging and Regenerative Medicine of Hunan Province, Changsha, 410008, China

    Xiaolong Sheng, Zhu Guo, Zhansheng Deng, Liyuan Jiang & Jianzhong Hu

  3. Department of Orthopedics, Changsha Hospital of Traditional Chinese Medicine, Changsha Eighth Hospital, Changsha, China

    Xiaolong Sheng

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  1. Xiaolong Sheng
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  4. Liyuan Jiang
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Contributions

L.Y. J. and J.Z. H. designed the study; X.L. S. and Z.G. made the data collection and analysis together; X.L. S. wrote the paper. L.Y. J., J.Z. H. and Z.S. D. revised the manuscript. All authors participated in the surgical operations and contributed to and approved the manuscript.

Corresponding author

Correspondence to Liyuan Jiang.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional ethics committee of Xiangya Hospital, Central South University, Changsha, China.

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The authors declare no competing interests.

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Sheng, X., Guo, Z., Deng, Z. et al. Posterior limited unilateral fenestration approach for treating patients with single-segment thoracic and lumbar tuberculosis. Acta Neurochir 164, 2637–2644 (2022). https://doi.org/10.1007/s00701-022-05342-3

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