title: Minimally invasive surgery through the interlaminar approach in the treatment of spinal tuberculosis: A retrospective study of 31 patients.
abstract: The aim of this study was to evaluate the efficacy of minimally invasive spinal decompression combined with local chemotherapy in treating patients with thoracic/lumbar tuberculosis (TB) and abscess compression of the spinal canal. Clinical data of 31 patients with thoracic/lumbar TB and spinal epidural abscess, admitted to our hospital between December 2005 and June 2014 were retrospectively analyzed. All patients received initial conservative treatment but achieved unsatisfactory results and then underwent minimally invasive spinal canal decompression, focus debridement and catheter drainage through a posterior interlaminar approach. Postoperatively, a short-course (1-2months) of local chemotherapy was given. The patients were followed up on a regular basis. The neurologic status was graded according to the American Spinal Injury Association (ASIA) score system. Kyphotic deformity was evaluated using Cobb angle measurement. Patients were followed up for an average of 37months (range: 12-96months). At the last follow-up, ASIA scores were improved in all patients, and there was a mild increase in the Cobb angle, but satisfactory spinal stabilization was achieved. Hepatorenal function, erythrocyte sedimentation rate and C-reactive protein levels all returned to normal. One complication was observed, where the patient had worsened deficit postoperatively but achieved a satisfactory recovery (from Grade C to Grade E) one year after a second surgery. Minimally invasive spinal canal decompression combined with local chemotherapy appears to be an effective treatment for patients with thoracic/lumbar TB and abscess compression in the spinal canal.
authors: Department of Orthopedics, Beijing Tsinghua Changgung Hospital & Medical Center, Tsinghua University. Beijing 102218, China.
authors: Huadong
authors: H
authors: Yang
authors: Department of Orthopedics, Pinggu Hospital of Capital Medical University, Pinggu, Beijing 101200, China.
authors: Kedong
authors: K
authors: Hou
authors: Department of Orthopedics, PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing 100853, China.
authors: Lin
authors: L
authors: Zhang
authors: Department of Orthopedics, PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing 100853, China. Electronic address: zhangxifengpla@163.com.
authors: Xifeng
authors: X
authors: Zhang
authors: Department of Orthopedics, PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing 100853, China.
authors: Yan
authors: Y
authors: Wang
authors: Department of Orthopedics, PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing 100853, China.
authors: Peng
authors: P
authors: Huang
authors: Department of Orthopedics, PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing 100853, China.
authors: Songhua
authors: S
authors: Xiao
mesh_terms: D000328:Adult; D000368:Aged; D019299:Decompression, Surgical / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications; D013904:Thoracic Vertebrae / Q000601:surgery*; D014399:Tuberculosis, Spinal / Q000188:drug therapy / Q000601:surgery*
keywords: Decompression; Interlaminar approach; Local chemotherapy; Minimally invasive surgery; Spinal tuberculosis