One-stage posterior approach for treating multilevel noncontiguous thoracic and lumbar spinal tuberculosis

Postgrad Med. 2019 Jan;131(1):73-77. doi: 10.1080/00325481.2019.1552824. Epub 2018 Dec 26.

Abstract

Objectives: Multilevel noncontiguous thoracic and lumbar spinal tuberculosis (MNST) is a relatively rare entity. The objective of this retrospective study was to investigate whether a technique involving a one-stage posterior debridement and decompression, combined with an intervertebral fusion and posterior instrumentation, is effective for treating MNST.

Methods: Thirteen patients, with an average age of 40.69 (18-67) years, who had MNST and were surgically treated in our department from January 2008 to October 2013, were reviewed.

Results: The average follow-up time was 37.54 ± 10.49 (19-58) months. The mean Cobb angle range was 15.69° ± 00A09.09° (-3° to 33°). The mean erythrocyte sedimentation rate (ESR) was 47.69 ± 9.30 mm/h (range 30-62 mm/h) before the operation. Neurological deficits were evaluated using the Frankel grade system. The mean Cobb angle decreased to 6.92° ± 3.93° postoperatively. Three months after the operation, the Cobb angle was 7.54° ± 4.35°, and the average ESR was 10.38 ± 4.54 mm/h that was normal for all cases in this retrospective observational study. Solid fusion was achieved in all cases. No severe complications occurred.

Conclusions: The study demonstrated that a one-stage posterior debridement and decompression, combined with an intervertebral fusion and posterior instrumentation, was effective for treating MNST.

Keywords: Multilevel; decompression; fusion; noncontiguous; posterior; spinal tuberculosis; surgical treatment.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / therapeutic use
  • Debridement / methods*
  • Decompression, Surgical / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spinal Fusion / methods*
  • Thoracic Vertebrae / pathology
  • Thoracic Vertebrae / surgery
  • Treatment Outcome
  • Tuberculosis, Spinal / surgery*
  • Young Adult

Substances

  • Antitubercular Agents