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A clinical study of internal fixation, debridement and interbody thoracic fusion to treat thoracic tuberculosis via posterior approach only

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Abstract

Purpose

We evaluated the clinical efficacy and feasibility of one-stage posterior internal fixation, debridement and interbody thoracic fusion in the treatment of thoracic tuberculosis.

Methods

Sixty adult patients with monosegmental thoracic tuberculosis were studied retrospectively: 34 men and 26 women with an average age of 37.5 years. Operating time, blood loss, time in bed, complications, neurological function, rate of deformity correction and rate of interbody fusion were investigated.

Results

All cases were followed up for 27.5 months on average. Average mean operating time was 251 min, evaluated blood loss during operation 780 ml, rate of kyphosis correction 79%, corrected kyphosis angle 25° and loss of corrected angle 1.2°. Patients whose neurological function improved accounted for 90.1%. Erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP) decreased to normal levels three months after operation. The rate of bone fusion was 100%, with a 100% cure rate. No severe complications or spinal cord injury occurred.

Conclusions

This approach can successfully remove the focus of tuberculosis with complete interbody thoracic fusion after operation, which restores spinal stability.

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References

  1. Houshian S, Poulsen S, Riegels-Nielsen P (2000) Bone and joint tuberculosis in Denmark: increase due to immigration. Acta Orthop Scand 71:312–315. doi:10.1080/000164700317411942

    Article  PubMed  CAS  Google Scholar 

  2. Almeida A (2005) Tuberculosis of the spine and spinal cord. Eur J Radiol 55:193–201. doi:10.1016/j.ejrad.2005.04.018

    Article  PubMed  Google Scholar 

  3. Issack PS, Boachie-Adjei O (2011) Surgical correction of kyphotic deformity in spinal tuberculosis. Int Orthop. doi:10.1007/s00264-011-1292-9

  4. Vidyasagar C, Murthy HK (1996) Spinal tuberculosis with neurological deficits. Natl Med J India 9:25–27

    PubMed  CAS  Google Scholar 

  5. Xue HB, Ma YZ, Chen X, Li HW, Cai XJ, Guo LX, Peng W (2007) Surgical treatment of spinal tuberculosis in aged. Zhonghua Wai Ke Za Zhi 45:1233–1236

    PubMed  Google Scholar 

  6. Jutte PC, Van Loenhout-Rooyackers JH (2006) Routine surgery in addition to chemotherapy for treating spinal tuberculosis. Cochrane Database Syst Rev:CD004532. DOI 10.1002/14651858.CD004532.pub2

  7. Dharmalingam M (2004) Tuberculosis of the spine-the Sabah experience. Epidemiology, treatment and results. Tuberculosis (Edinb) 84:24–28

    Article  CAS  Google Scholar 

  8. Ramdurg SR, Gupta DK, Suri A, Sharma BS, Mahapatra AK (2009) Spinal intramedullary tuberculosis: a series of 15 cases. Clin Neurol Neurosurg 111:115–118. doi:10.1016/j.clineuro.2008.09.029

    Article  PubMed  Google Scholar 

  9. Jain AK (2010) Tuberculosis of the spine: a fresh look at an old disease. J Bone Joint Surg Br 92:905–913. doi:10.1302/0301-620X.92B7.24668

    Article  PubMed  CAS  Google Scholar 

  10. Zhang HQ, Wang YX, Guo CF, Liu JY, Wu JH, Chen J, Guo D, Tang MX (2010) One-stage posterior approach and combined interbody and posterior fusion for thoracolumbar spinal tuberculosis with kyphosis in children. Orthopedics 33:808. doi:10.3928/01477447-20100924-10

    PubMed  Google Scholar 

  11. Zhang HQ, Wang YX, Guo CF, Zhao D, Deng A, Wu JH, Liu JY (2011) One-stage posterior focus debridement, fusion, and instrumentation in the surgical treatment of cervicothoracic spinal tuberculosis with kyphosis in children: a preliminary report. Childs Nerv Syst 27:735–742. doi:10.1007/s00381-010-1319-3

    Article  PubMed  CAS  Google Scholar 

  12. Sihoe AD, Shiraishi Y, Yew WW (2009) The current role of thoracic surgery in tuberculosis management. Respirology 14:954–968. doi:10.1111/j.1440-1843.2009.01609.x

    Article  PubMed  Google Scholar 

  13. Blasberg JD, Donington JS (2010) Infections and radiation injuries involving the chest wall. Thorac Surg Clin 20:487–494. doi:10.1016/j.thorsurg.2010.06.003

    Article  PubMed  Google Scholar 

  14. Lee SF, Lawrence D, Booth H, Morris-Jones S, Macrae B, Zumla A (2010) Thoracic empyema: current opinions in medical and surgical management. Curr Opin Pulm Med 16:194–200. doi:10.1097/MCP.0b013e32833883f5

    PubMed  Google Scholar 

  15. Pezzella AT, Fang W (2008) Surgical aspects of thoracic tuberculosis: a contemporary review–part 1. Curr Probl Surg 45:675–758. doi:10.1067/j.cpsurg.2008.06.003

    Article  PubMed  Google Scholar 

  16. Muthukumar N, Venkatesh G, Senthilbabu S, Rajbaskar R (2006) Surgery for intramedullary tuberculoma of the spinal cord: report of 2 cases. Surg Neurol 66:69–74; discussion 74. DOI 10.1016/j.surneu.2005.10.024

    Google Scholar 

  17. LoBue PA, Enarson DA, Thoen TC (2010) Tuberculosis in humans and its epidemiology, diagnosis and treatment in the United States. Int J Tuberc Lung Dis 14:1226–1232

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, Changsha, 410008, People’s Republic of China

    Hongqi Zhang, Shu Huang, Hubing Guo, Lei Ge, Bin Sheng, Yuxiang Wang, Chaofeng Guo & Mingxing Tang

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  1. Hongqi Zhang
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  2. Shu Huang
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  3. Hubing Guo
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  4. Lei Ge
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  5. Bin Sheng
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  6. Yuxiang Wang
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  7. Chaofeng Guo
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  8. Mingxing Tang
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Corresponding author

Correspondence to Hongqi Zhang.

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Author contributions

All authors contributed to the design and performance of the experiment and wrote the manuscript and approved the final version.

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Zhang, H., Huang, S., Guo, H. et al. A clinical study of internal fixation, debridement and interbody thoracic fusion to treat thoracic tuberculosis via posterior approach only. International Orthopaedics (SICOT) 36, 293–298 (2012). https://doi.org/10.1007/s00264-011-1449-6

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  • DOI: https://doi.org/10.1007/s00264-011-1449-6

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