title: Thoracolumbar spinal tuberculosis with psoas abscesses treated by one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural drainage.
abstract: OBJECTIVE
  Retrospective analysis of the clinical efficacy and feasibility of patients with thoracolumbar spinal tuberculosis with psoas abscesses treated by one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural drainage.
  
  
  METHODS
  A total of 18 patients with thoracolumbar tuberculosis (TB), between February 2007 and February 2011, underwent one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural drainage. And the clinical efficacy was evaluated based on surgery duration time, the blood loss, the postural drainage of time, neurological status that was recorded by American Spinal Injury Association (ASIA) Impairment Scale, the fate of bone graft fusion, kyphosis angle, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), which were collected at certain time.
  
  
  RESULTS
  The average follow-up period was 34 months (range 18-48 months). 18 patients suffered from seriously neurological deficits pre-operatively, of which 16 patients returned to normal at final follow-up. The surgery duration time was 197 ± 37.9 min, and the blood loss was 815 ± 348.5 ml. The postural drainage of time was 7.2 ± 2.7 days. The psoas abscesses disappeared in all cases, within the time range of 6-9 months (mean 7.4 ± 1.2 months). All patients of the grafted bones were thoroughly fused, with a fusion time ranging from 4 to 12 months (mean 7.8 months). Kyphosis angle was 44.32 ± 7.26° on average pre-operative and returned to 11.72 ± 2.85° at 6 weeks after operation; kyphosis angle was 13.10 ± 2.39° at final follow-up. The values of ESR and CRP were significant declined at 6 weeks post-operative, and returned to normal levels at final follow-up.
  
  
  CONCLUSIONS
  With standardized anti-TB chemotherapy, thoracolumbar spinal tuberculosis with psoas abscesses could be effectively treated by one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural drainage.
authors.affiliation: Department of Spine Surgery, The Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, 410008, Hunan, People's Republic of China. xiaoyangpang@163.com
authors.forename: Xiaoyang
authors.initials: X
authors.lastname: Pang
authors.forename: Xiongjie
authors.initials: X
authors.lastname: Shen
authors.forename: Ping
authors.initials: P
authors.lastname: Wu
authors.forename: Chenke
authors.initials: C
authors.lastname: Luo
authors.forename: Zhengquan
authors.initials: Z
authors.lastname: Xu
authors.forename: Xiyang
authors.initials: X
authors.lastname: Wang
mesh_terms: D000328:Adult; D003646:Debridement; D015916:Drainage, Postural; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009984:Orthopedic Fixation Devices; D019637:Orthopedic Procedures / Q000379:methods; D016659:Psoas Abscess / Q000150:complications*; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000601:surgery; D014399:Tuberculosis, Spinal / Q000150:complications* / Q000601:surgery*; D055815:Young Adult