[A surgical approach to tuberculosis of the thoracic spine and kyphotic deformity and compression of the spinal cord].
In patients with tuberculosis of thoracic vertebrae, kyphotic deformity and compression of the spinal cord involves resection of the involved portion and revision of the vertebral column. Resection was performed with a chisel that has an edge stop. Thus, 2 anterior and 2 posterior incisions (grooves) and a cross bed between them are prepared after resection on adjacent surfaces. The anterior epidural space is revised, by setting the spinal cord free from compressing agents. Three-four posterior rib ends are preliminary crossed above or below the apex of the hump at the level of the ends of transverse processes (desirably on both sides). A spinal deformity-correcting apparatus comprises an anterior loose half and posterior active part. Their bases are fixed on the laths of an operating table at the level of gibbus. The thrust pelots of an anterior tubule are adapted at the level of the presternum and, lower, at the base of the xiphisternum. Active pelots are set paragibbaly. By rotating the holder of the posterior tubule, the vertebral column is pressed down, correcting deformity by 30-40 degrees. A long posterior autograft and an anterior autograft are placed into the prepared incisions, by making spondylodesis and plastic repair of the anterior wall of the vertebral column. Short autografts cut from the posterior rib ends (which becoming superfluous) are tightly inserted between them. The grafts are covered with soft tissues and mediatinal pleura; the ends of the crossed ribs are sown together with transcostal sutures. The operative wound are sown with transcostal and intercostal sutures. A drain is taken through the ninth intercostal space.
Kushkhabiev
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D004867:Equipment Design; D006801:Humans; D007738:Kyphosis / Q000150:complications* / Q000601:surgery; D013117:Spinal Cord Compression / Q000150:complications* / Q000601:surgery; D013123:Spinal Fusion / Q000295:instrumentation*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000150:complications / Q000601:surgery*