[Effectiveness and safety assessments of thoracoscopic thoracic tuberculosis clearance and internal fixation with bone grafting supported by digital technology].
OBJECTIVE
To explore the effectiveness and safety of treatment of thoracic tuberculosis with thoracoscope supported by digital technology.


METHODS
Between June 2010 and February 2012, 11 patients with thoracic tuberculosis were treated and the clinical data were retrospectively analyzed. There were 7 males and 4 females with an average age of 23.6 years (range, 16-47 years) and an average disease duration of 16 months (range, 6-18 months). Two vertebral bodies and one intervertebral space were involved at T6-ll. At preoperation, the neurologic function degree was classified as Frankel grade E. Three dimensional reconstruction of thorax and spine and surgical procedure design (including focal clearance, bone grafting, and screw fixation) were done at SUPERIMAGE workstation. Surgery procedures were conducted following the preoperative designs.


RESULTS
The operative procedures were consistent with preoperative designs. All of these operations were successfully performed. The mean time of operation was 146 minutes (range, 120-180 minutes); the mean blood loss was 120 mL (range, 100-150 mL); the mean indwelling time of closed thoracic drainage was 38 hours (range, 24-48 hours); and the mean hospitalization time was 4.6 days (range, 3-5 days). Eleven patients were followed up 12-25 months (mean, 16 months). No complication of nerve damage, incision pain and infection, or pulmonary infection was observed. Rigid fixation and born fusion were obtained at last follow-up; no obvious change of thoracic vertebral alignment was detected and no internal fixation failure occurred.


CONCLUSIONS
It is a minimally invasive, effective, and safe method to treat thoracic tuberculosis with thoracoscope supported by digital technology.
Limin
L
Liu
Yueming
Y
Song
Quan
Q
Gong
Chunguang
C
Zhou
Yonggang
Y
An
D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods; D003646:Debridement / Q000379:methods*; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D021621:Imaging, Three-Dimensional; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D013906:Thoracoscopy; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult