title: Minimum 5-year follow-up outcomes for single-stage transpedicular debridement, posterior instrumentation and fusion in the management of thoracic and thoracolumbar spinal tuberculosis in adults.
abstract: OBJECTIVE
  The aim of this retrospective clinical study is to evaluate the long-term outcomes for single-stage transpedicular debridement, posterior instrumentation and fusion in the management of thoracic and thoracolumbar spinal tuberculosis in adults.
  
  
  METHODS
  Fifty-nine adult patients with thoracic and thoracolumbar spinal tuberculosis underwent single-stage transpedicular debridement, posterior instrumentation and fusion. These patients were followed for a minimum of 5 years. Patients were assigned to one of two groups according to the infected anatomic segment. In the thoracic spinal tuberculosis group, there were 28 cases (17 males, 11 females) with a mean age of 38.9 years; in the thoracolumbar spinal tuberculosis group, there were 31 cases (19 males, 12 females) with a mean age of 40.3 years. All cases were evaluated clinically using the visual analog scale (VAS), Kirkaldy-Willis criteria and the American Spinal Injury Association (ASIA) impairment scale. Radiographs were performed for measuring the angle of kyphosis and scoliosis. Complications related to surgery were recorded.
  
  
  RESULTS
  All patients successfully resolved their infections, experienced one or more ASIA grades of improvement, and improved in their VAS pain scores at final follow-up. In both groups, patient-reported outcomes reached over 90% excellent or good results using Kirkaldy-Willis criteria. The loss of kyphotic angle correction was 2.6° in the thoracic spinal tuberculosis group and 3.2° in the thoracolumbar spinal tuberculosis group. No scoliosis was observed in either group. Fifty-eight (98.3%) cases achieved solid bony fusion. In the thoracolumbar spinal tuberculosis group, one patient experienced screw loosening, and another patient with nonunion and rod breakage underwent revision surgery.
  
  
  CONCLUSIONS
  The technique of single-stage transpedicular debridement, posterior instrumentation and fusion is an effective method for the treatment of thoracic and thoracolumbar spinal tuberculosis in adults. Long-term postoperative clinical and radiological outcomes were satisfactory.
authors.affiliation: a Department of Spine Surgery , Xiangya Hospital of Central South University , Changsha , Hunan , China.
authors.forename: Penghui
authors.initials: P
authors.lastname: Zhang
authors.affiliation: a Department of Spine Surgery , Xiangya Hospital of Central South University , Changsha , Hunan , China.
authors.forename: Wei
authors.initials: W
authors.lastname: Peng
authors.affiliation: a Department of Spine Surgery , Xiangya Hospital of Central South University , Changsha , Hunan , China.
authors.forename: Xiyang
authors.initials: X
authors.lastname: Wang
authors.affiliation: a Department of Spine Surgery , Xiangya Hospital of Central South University , Changsha , Hunan , China.
authors.forename: Chengke
authors.initials: C
authors.lastname: Luo
authors.affiliation: a Department of Spine Surgery , Xiangya Hospital of Central South University , Changsha , Hunan , China.
authors.forename: Zhengquan
authors.initials: Z
authors.lastname: Xu
authors.affiliation: a Department of Spine Surgery , Xiangya Hospital of Central South University , Changsha , Hunan , China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zeng
authors.affiliation: a Department of Spine Surgery , Xiangya Hospital of Central South University , Changsha , Hunan , China.
authors.forename: Zheng
authors.initials: Z
authors.lastname: Liu
authors.affiliation: a Department of Spine Surgery , Xiangya Hospital of Central South University , Changsha , Hunan , China.
authors.forename: Yupeng
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: a Department of Spine Surgery , Xiangya Hospital of Central South University , Changsha , Hunan , China.
authors.forename: Lei
authors.initials: L
authors.lastname: Ge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001863:Bone Screws; D003646:Debridement / Q000379:methods*; D005260:Female; D006801:Humans; D016268:Internal Fixators; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000209:etiology; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011182:Postoperative Care; D012086:Reoperation; D012189:Retrospective Studies; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000209:etiology; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D000995:Antitubercular Agents
keywords: Pott’s disease; interbody grafting; posterior midline approach; posterior spinal instrumentation; thoracic spine