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

Zeng, Hao; Zhang, Penghui; Shen, Xiongjie; Luo, Chengke; Zhang, Xu; Zhang, Yupeng; Liu, Zheng; Wang, Xiyang

doi:10.1186/s12891-015-0640-0

Cited by 42 publications

(40 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The essence of the transfacet approach is to provide safe and effective access for the removal of herniated discs with relatively low morbidity [ 11 , 22 ]. The anatomical characteristics of TDH are similar to those of TST since Mycobacterium tuberculosis is also prone to affect the anterior column including the intervertebral disc and its upper and lower adjoining vertebral bodies (peridiscal) [ 14 , 23 ]. In light of this, we used a posterior transfacet approach for the treatment of TST, as described for the treatment for TDH.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the posterior approach can provide a better correction of the kyphosis which most frequently occurs with TST. Anatomically, there is lesion of the intervertebral disk space in TST [ 13 , 14 ], which is similar to that in TDH. Therefore, the authors believe that TST patients can be managed adequately by the posterior modified transfacet approach.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Preliminary experience in treating thoracic spinal tuberculosis via a posterior modified transfacet debridement, instrumentation, and interbody fusion

et al. 2018

View full text Add to dashboard Cite

BackgroundPosterior transfacet approach has been proved to be a safe and effective access to treat thoracic disc herniation. However, the therapeutic effect and safety of modified transfacet approach for treating thoracic spinal tuberculosis (TST) has not been reported in the clinical literature. In this study, the clinical efficacy and safety of a single-stage posterior modified transfacet debridement, posterior instrumentation, and interbody fusion for treating TST were retrospectively evaluated.Patients and methodsFrom 2009 to 2014, 37 patients with TST underwent a posterior modified transfacet debridement, interbody fusion following posterior instrumentation, under the cover of 18 months of antituberculosis chemotherapy. The patients were evaluated preoperatively and postoperatively in terms of Frankel Grade, visual analog scale (VAS) pain score, kyphotic Cobb angle, and bony fusion.ResultsThe follow-up time was 39.8 ± 5.1 months (29–50 months). No postoperative complication or recurrence of spinal tuberculosis was observed. Definitive bony fusion was achieved in all patients. At the final follow-up, 2 cases were rated as Frankel grade D, 35 as grade E. VAS was recovered from 8.4 ± 1.0 cm to 0.4 ± 0.8 cm. The kyphotic angles were corrected from 29.4 ± 10.9° to 17.6 ± 6.3°. Using the Kirkaldy-Willis criteria, functional outcome was excellent in 29 patients, good in 7, and fair in 1.ConclusionsOur preliminary results showed that single-stage posterior modified transfacet debridement, posterior instrumentation, and interbody fusion are effective and safe surgical options for treating TST.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preliminary experience in treating thoracic spinal tuberculosis via a posterior modified transfacet debridement, instrumentation, and interbody fusion

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Key words Lumbar tuberculous; Single-stage posterior debridement; Anterior column support; Bone fusion; Nonstructural bone grafting; Structural bone grafting Background Spinal tuberculous (STB) is the most common type of extra-pulmonary tuberculosis [1], and accounts for nearly 50% of skeletal tuberculosis. STB is prone to occur at the lower thoracic and lumbar spine, and leads to vertebral collapse, kyphosis and even paralysis [2][3]. The goals of spinal tuberculosis surgery are to debride lesions, decompress spinal cord and reconstruct spinal stability.…”

Section: Introductionmentioning

confidence: 99%

Nonstructural versus structural bone grafting in the treatment of lumbar tuberculosis: a retrospective cohort study

Zhao

Peng³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Various bone grafting have been reported to achieve anterior column support and bone fusion after one stage posterior debridement in the treatment of lumbar tuberculosis. However, nonstructural bone grafting has been rarely studied. This study aimed to compare the efficacy of nonstructural bone grafting versus structural bone grafting in the treatment of lumbar tuberculosis.Patients and methods We retrospectively reviewed patients with nonstructural (n=27) and structural (n=22) bone grafting after single-stage posterior debridement and instrumentation for lumbar tuberculosis with at least 24 months of follow-up. Plain radiographs, magnetic resonance imaging, computed tomography scans, and health-related outcomes (e.g. Visual Analog Scale for back pain, the Oswestry Disability Index) were collected before surgery and at follow-up.Results Both nonstructural and structural bone grafting were associated with significant improvements in the quality of life parameters, the laboratory tests and the Cobb angle of local kyphosis. A slight loss of Cobb angle correction was observed in two groups. Nonstructural bone grafting resulted in the significantly less operation duration, blood loss and lower bone fusion rate than structural bone grafting group. There were three complications in the nonstructural bone grafting and four complications in the structural bone grafting group, with no significant difference between two groups. Conclusions Nonstructural bone grafting can achieve anterior column support with less surgical trauma and simpler surgical procedure than structural bone grafting, but the lower rate of grafted bone fusion should be taken into consideration when choosing nonstructural bone grafting. Key words Lumbar tuberculous; Single-stage posterior debridement; Anterior column support; Bone fusion; Nonstructural bone grafting; Structural bone grafting

show abstract

“…The posterior approach involves the use of a spinal instrumentation structure with screws and rods to correct the kyphotic deformity and decompress the spinal cord, facilitating treatment of tuberculous spondylodiscitis [11,12] are lacking. To date, a comparative study evaluating the therapeutic bene ts of these two xations technique for Pott's disease has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Long-segment versus short-segment fixation through a posterior approach for tuberculous spondylodiscitis of the mid-thoracic spine in adults: a study of mid- to long-term efficacy

Wang

Chen

et al. 2020

Preprint

Self Cite

View full text Add to dashboard Cite

Background This retrospective study aimed to perform comparatively evaluate the mid- to long-term efficacy of long-segment and short-segment fixations via the posterior approach as treatment for tuberculous spondylodiscitis in the mid-thoracic spine. Methods A total of 95 patients with tuberculous spondylodiscitis in the mid-thoracic spine underwent surgery via the posterior approach including single-stage posterior debridement, interbody fusion, and pedicle screw fixation. Long-segment fixations were performed for 46 patients (group A), while short-segment fixations were performed for the other 49 patients (group B). Clinical and radiological outcomes were assessed during mid- to long-term follow-up. Results The average follow-up periods for groups A and B were 75.5 ± 11.8 and 76.8 ± 11.6 months, respectively. The operative time and intraoperative blood loss were lower in group B than in group A (P < 0.05). Both management approaches significantly corrected the kyphotic deformity detected either in the early postoperative period or at the final visit after long-term follow-up (P > 0.05). Bony fusion was generated after average periods of 10.8 ± 2.1 months and 11.0 ± 2.0 months in groups A and B, respectively. Favorable outcomes were observed on assessment of neurological function and patients’ well-being at the final follow-up. Conclusion No therapeutic differences were observed between long-segment and short-segment fixation as surgical treatment for mid-thoracic Pott’s disease during mid- to long-term follow-up. Kyphotic deformity and neurological impairment were significantly relieved via both posterior fixation approaches, with patients’ well-being reaching a favorable level. Moreover, short-segment fixation led to less blood loss and required a shorter operative time.

show abstract

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

Cited by 42 publications

References 24 publications

Preliminary experience in treating thoracic spinal tuberculosis via a posterior modified transfacet debridement, instrumentation, and interbody fusion

Preliminary experience in treating thoracic spinal tuberculosis via a posterior modified transfacet debridement, instrumentation, and interbody fusion

Nonstructural versus structural bone grafting in the treatment of lumbar tuberculosis: a retrospective cohort study

Long-segment versus short-segment fixation through a posterior approach for tuberculous spondylodiscitis of the mid-thoracic spine in adults: a study of mid- to long-term efficacy

Contact Info

Product

Resources

About