title: One-stage posterior-only approach in surgical treatment of single-segment thoracic spinal tuberculosis with neurological deficits in adults: a retrospective study of 34 cases.
abstract: BACKGROUND
  There are quite a few controversies on the surgical management of single-segment thoracic spinal tuberculosis with neurological deficits (STSTND). In this study, the clinical efficacy and feasibility of one-stage posterior-only transpedicular debridement, interbody fusion, and posterior instrumentation for treating STSTND in adults were retrospectively evaluated.
  
  
  METHODS
  Thirty-four cases with STSTND underwent one-stage posterior-only transpedicular debridement, interbody fusion and posterior instrumentation at the same institution from January 2003 to January 2013. Follow-up time was 34.4 ± 10.2 months (range, 18-48 months), and kyphosis angle was 34.1 ± 12.3°. The American Spinal Injury Association (ASIA) classification of spinal cord injury was employed to evaluate neurological deficits, while visual analogue scale (VAS) was employed to assess the degree of pain. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were used to evaluate the activity of tuberculosis (TB).
  
  
  RESULTS
  All 34 patients with spinal tuberculosis (ST) were completely cured, and there was no recurrence of TB. Postoperative kyphosis angle was 8.2 ± 1.8°, and there was no significant loss of correction during the final follow-up. Solid fusion was achieved and pain was relieved in all cases. Neurological condition in all patients improved after surgery.
  
  
  CONCLUSIONS
  One-stage posterior-only transpedicular debridement, interbody fusion, and posterior fixation followed by chemotherapy seems to be adequate for obtaining satisfactory healing of single-segment thoracic spinal tuberculosis with neurological deficits. Careful patient selection is critical to the successful outcome with this technique.
authors.affiliation: Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan, 410008, People's Republic of China. 1985008521@qq.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Zeng
authors.affiliation: Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan, 410008, People's Republic of China. wjwszyjbm@163.com.
authors.forename: Penghui
authors.initials: P
authors.lastname: Zhang
authors.affiliation: Department of Spine Surgery, Hunan Provincial People's Hospital, Changsha, Hunan, 410005, People's Republic of China. wqlwqwxy@163.com.
authors.forename: Xiongjie
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan, 410008, People's Republic of China. 458843975@qq.com.
authors.forename: Chengke
authors.initials: C
authors.lastname: Luo
authors.affiliation: Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan, 410008, People's Republic of China. 523631750@qq.com.
authors.forename: Zhengquan
authors.initials: Z
authors.lastname: Xu
authors.affiliation: Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan, 410008, People's Republic of China. 190818555@qq.com.
authors.forename: Yupeng
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan, 410008, People's Republic of China. 229061878@qq.com.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan, 410008, People's Republic of China. 2621132371@qq.com.
authors.forename: Xiyang
authors.initials: X
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*