title: Debridement, interbody graft using titanium mesh cages, posterior instrumentation and fusion in the surgical treatment of multilevel noncontiguous spinal tuberculosis in elderly patients via a posterior-only.
abstract: OBJECTIVE
  To analyse the efficacy and feasibility of surgical management for elderly patients with multilevel non-contiguous spinal tuberculosis(MNSTB)by using one-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation and fusion.
  
  
  METHODS
  From September 2009 to October 2013, 15 elderly patients with MNSTB were treated with one-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation and fusion. There were 10 males and 5 females with a mean age of 63.2 years (range: 60-68 years) at the time of surgery. The mean follow-up time was 40 months(range 26-68 months). Patients were evaluated before and after surgery in terms of erythrocyte sedimentation rate(ESR), neurological status, pain and kyphotic angle.
  
  
  RESULTS
  The spinal tuberculosis was completely cured, and the grafted bones were fused in all 15 patients. There were no recurrent tuberculous infections. The ESR reached a normal level within 3 months in all patients. The ASIA neurological classification improved in all cases, and pain relief was reported by all patients. The average preoperative kyphosis was 20.1° (range 8-38°) and decreased to 7.6° (range 1-18°) postoperatively. There was no significant loss of the correction at the latest follow-up.
  
  
  CONCLUSIONS
  Our results showed that one-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation and fusion was an effective treatment for elderly patients with MNSTB. It is characterized by minimum surgical trauma, good neurological recovery, and good correction of kyphosis.
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Yu-Xiang
authors.initials: YX
authors.lastname: Wang
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China. Electronic address: zhanghongqi9996@sina.com.
authors.forename: Hong-Qi
authors.initials: HQ
authors.lastname: Zhang
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Ming-Xing
authors.initials: MX
authors.lastname: Tang
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Chao-Feng
authors.initials: CF
authors.lastname: Guo
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Ang
authors.initials: A
authors.lastname: Deng
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Qile
authors.initials: Q
authors.lastname: Gao
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Jian-Huang
authors.initials: JH
authors.lastname: Wu
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Jin-Yang
authors.initials: JY
authors.lastname: Liu
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D003646:Debridement / Q000295:instrumentation / Q000379:methods*; D019299:Decompression, Surgical; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013526:Surgical Mesh; D014025:Titanium; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology
chemical_list: D014025:Titanium
keywords: Elderly patients; Multilevel non-contiguous; Posterior approach; Spinal tuberculosis; Titanium mesh cages