title: Surgical management for multilevel noncontiguous thoracic spinal tuberculosis by single-stage posterior transforaminal thoracic debridement, limited decompression, interbody fusion, and posterior instrumentation (modified TTIF).
abstract: OBJECTIVE
  Multilevel noncontiguous thoracic spinal tuberculosis has rarely been reported in the literature. We present a retrospective clinical study of 14 patients with multilevel noncontiguous thoracic spinal tuberculosis treated by single-stage posterior transforaminal thoracic debridement, limited decompression, interbody fusion, and posterior instrumentation (modified TTIF) and determine the clinical effectiveness of such surgical treatment for MNTST.
  
  
  METHODS
  Fourteen patients with multilevel noncontiguous thoracic spinal tuberculosis were treated with modified TTIF. The mean follow-up was 27.36 ± 10.46 months (range 13-42 months). The kyphotic angle ranged from -2° to 47° before operation, with an average of 19.21° ± 12.63°. The erythrocyte sedimentation rate (ESR) of patients upon admission ranged from 30 to 62 mm/h before operation, with an average of 46.43 ± 10.77 mm/h. The Frankel Grade was used to evaluate the neurological deficits.
  
  
  RESULTS
  The average ESR got normal (8.14 ± 5.89 mm/h) within 3 months in all patients. The average kyphotic angle decreased to 8.07° ± 6.91° postoperatively. Mean deformity angle was measured as 8.79° ± 7.29° at the last visit. Solid fusion was achieved in all cases. Neurologic status of the 12 patients with preoperative neurologic deficit was 6 with grade D recovered to normal; 2 with grade B, both of them to grade D; 4 with grade C, 2 to grade D, 1 to grade E, and 1 still in grade C.
  
  
  CONCLUSIONS
  Modified TTIF can be an effective treatment method of multilevel noncontiguous thoracic spinal tuberculosis.
authors.affiliation: Department of Spine Surgery, Xiangya Hospital of Central South University, Xiangya Road 87, 410008 Changsha, China. zhq9996@163.com
authors.forename: Hong-qi
authors.initials: HQ
authors.lastname: Zhang
authors.forename: Min-zhong
authors.initials: MZ
authors.lastname: Lin
authors.forename: Kai-ying
authors.initials: KY
authors.lastname: Shen
authors.forename: Lei
authors.initials: L
authors.lastname: Ge
authors.forename: Jing-song
authors.initials: JS
authors.lastname: Li
authors.forename: Ming-xing
authors.initials: MX
authors.lastname: Tang
authors.forename: Jian-huang
authors.initials: JH
authors.lastname: Wu
authors.forename: Jin-yang
authors.initials: JY
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D003646:Debridement / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods*; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000188:drug therapy / Q000601:surgery*
chemical_list: D000995:Antitubercular Agents