title: [Surgical treatment for thoracic spinal tuberculosis with intraspinal abscesses by unilateral vertebral lamina limited decompression via posterior-only approach].
abstract: OBJECTIVE
  To investigate the clinical efficacy and feasibility of surgical treatment for thoracic spinal tuberculosis with intraspinal abscesses by internal fixation, unilateral vertebral lamina limited decompression, debridement, together with interbody and posterior fusion via a posterior only approach.
  
  
  METHODS
  A total of 37 pantients (24 males and 13 females) with thoracic spinal tuberculosis complicated with intraspinal abscess lesions were admitted to our hospital, with age 13-68(39.7 ± 9.1) years old. Spinal lesions of segmental kyphosis Cobb angle was 8°-62° (29.6° ± 3.6°). Frankel grade system was used to assess neurological function. According to the system, there were 3, 7, 19 and 8 cases for grade B, C, D and E, respectively. All 37 cases were treated with internal fixation, unilateral vertebral lamina limited decompression, debridement, together with interbody and posterior fusion via a posterior only approach.
  
  
  RESULTS
  The mean duration for follow-up was 24-90 (53.0 ± 15.7) months. Intraoperative dural tear occurred in 1 cases with cerebrospinal fluid leakage after operation; 2 cases showed postoperative neurological complications; delayed wound healing occurred in 2 cases. The postoperative kyphotic angle was 5°-21° (8.3° ± 1.3°). The kyphotic angle was 8°-26° (10.1° ± 1.9°) at the last follow-up. By the time of the last follow-up, all patients with preoperative neurological symptoms improved at different degree. According to Frankel classification, 2 cases recovered from grade B to D, 1 case from grade B to E, 3 cases from grade C to D, 4 cases from grade C to E, 13 cases from grade D to E. No failure in fixation and pseudarthrosis. All patients obtained satisfactory bone graft fusion.
  
  
  CONCLUSIONS
  Posterior internal fixation, unilateral vertebral lamina limited decompression, debridement, together with interbody and posterior fusion might be a effective and feasible method for treatment of thoracic spinal tuberculosis with intraspinal abscess lesions.
authors.affiliation: Department of Spinal Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Shaohua
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Spinal Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Zhansheng
authors.initials: Z
authors.lastname: Deng
authors.affiliation: Department of Spinal Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Spinal Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: An
authors.initials: A
authors.lastname: Wang
authors.affiliation: Department of Spinal Surgery, Xiangya Hospital, Central South University, Changsha 410008, China.
authors.forename: Liyuan
authors.initials: L
authors.lastname: Jiang
mesh_terms: D000038:Abscess / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D002648:Child; D003646:Debridement; D019299:Decompression, Surgical; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D007738:Kyphosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000473:pathology / Q000601:surgery*; D055815:Young Adult