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European Spine Journal
Published in: European Spine Journal 4/2016

01-04-2016 | Original Article

The role of costotransverse radical debridement, fusion and postural drainage in the surgical treatment of multisegmental thoracic spinal tuberculosis: a minimum 5-year follow-up

Authors: Xin Hua Yin, Shao Hua Liu, Jin Song Li, Yong Chen, Xiong Ke Hu, Ke Feng Zeng, Hong Gui Yu, Zhen Hai Zhou, Hong Qi Zhang

Published in: European Spine Journal | Issue 4/2016

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Abstract

Purpose

We present a retrospective study of patients with multilevel contiguous tuberculous spondylitis of thoracic region that underwent single-stage posterolateral debridement and fusion and following posterior instrumentation.

Methods

From June 2000 to March 2009, 870 consecutive spinal tubercular patients including 36 patients who were diagnosed and treated as multilevel contiguous thoracic spinal tuberculosis in our institution. Apart from five patients being treated conservatively, the 31 cases received surgery by single-stage posterolateral debridement, fusion, following posterior instrumentation and postural drainage. The patients were evaluated based on the Frankel scoring system, kyphotic Cobb angle, and visual analog scale (VAS) pain score.

Results

The mean duration of postoperative follow-up was 79.2 ± 9.9 months (range 62–98 months). Neither mortalities nor any major complications were found. Solid bony fusion was achieved in all patients. No patients with neurological deficit deteriorated postoperatively. According to Frankel scoring system, 7 cases were rated as Grade D, 24 cases as Grade E at last follow-up. The average preoperative Cobb’s angle was 32° (range 21°–39°). The average early postoperative Cobb’s angle was 23° (range 15°–32°). The mean latest postoperative Cobb’s angle was 26° (range 20°–32°), with a small loss of correction at last follow-up. Pre-op VAS was 8.8 ± 0.7 (range 7–10) and final follow-up was 1.8 ± 1.1. There was a significant difference of VAS between preoperation and the final follow-up.

Conclusions

One-stage surgical treatment for multilevel contiguous spinal tuberculosis by posterolateral debridement, fusion, posterior instrumentation can be an effective and feasible treatment method.
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Metadata
Title
The role of costotransverse radical debridement, fusion and postural drainage in the surgical treatment of multisegmental thoracic spinal tuberculosis: a minimum 5-year follow-up
Authors
Xin Hua Yin
Shao Hua Liu
Jin Song Li
Yong Chen
Xiong Ke Hu
Ke Feng Zeng
Hong Gui Yu
Zhen Hai Zhou
Hong Qi Zhang
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
European Spine Journal / Issue 4/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-015-4283-5

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Answer to the Letter to the Editor of J. M. Duart-Clemente et al. concerning “Systematic review of the effect of dynamic fixation systems compared with rigid fixation in the anterior cervical spine” by Campos RR, Botelho RV; Eur Spine J (2014); 23(2):298–304

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