[Modified single-stage transpedicular decompression, debridement, and posterior instrumentation in treatment of thoracic tuberculosis].
OBJECTIVE
To investigate the effectiveness and feasibility of modified single-stage transpedicular decompression, debridement, and posterior instrumentation in treatment of thoracic tuberculosis.


METHODS
Between January 2005 and December 2009, 22 cases of thoracic tuberculosis were treated with modified single-stage transpedicular decompression, debridement, and posterior instrumentation. There were 12 males and 10 females with an average age of 39.4 years (range, 22-52 years). The mean disease duration was 1.2 years (range, 3 months to 10 years). The involved vertebral bodies were T5-12, including 2 segments in 17 cases and 3 segments in 5 cases. The kyphosis Cobb angle was (31.2 +/- 14.5) degrees before operation. According to Frankel score system for neurological deficits, 2 cases were classified as grade A, 1 case as grade B, 8 cases as grade C, 5 cases as grade D, 1 case as grade E, and 5 cases had no neurological deficits before operation.


RESULTS
All incisions healed by first intention. All patients were followed up 22.2 months on average (range, 12-65 months). Pain in low back was relieved in varying degrees 2 weeks after operation. Fusion was achieved in the bone implant area at 3 months after operation. According to Frankel score system, 1 case was rated as grade B, 2 cases as grade C, 4 cases as grade D, 7 cases as grade E, and 8 cases had no neurological deficits at last follow-up. The kyphosis Cobb angle was (16.2 +/- 3.6) degrees, showing significant difference when compared with the value before operation (t = 5.952, P = 0.001). No loosening, emersion, breakage of internal fixation or pneumothorax occurred 1 year after operation.


CONCLUSIONS
Single-stage transpedicular decompression and posterior instrumentation is an effective and safe method in treatment of thoracic tuberculosis.
Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, PR China.
Cheng
C
Li
Dawei
D
He
Wen
W
Hu
Xinghua
X
Yang
Yingjie
Y
Ni
Ming
M
Li
D000328:Adult; D016025:Bone Transplantation / Q000379:methods; D003646:Debridement; D019299:Decompression, Surgical; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000601:surgery*; D055815:Young Adult