Affiliation:
1. Department of Orthopaedics Surgery, Second Affiliated Hospital of Anhui Medical University, Hefei, China
2. Department of Orthopedics Surgery, Second Affiliated Hospital of Anhui Medical University, Hefei, China
Abstract
Abstract
Background The purpose of this study was to evaluate the clinical outcomes of thoracic and lumbar spinal tuberculosis treated with isolated posterior instrumentation without radical
debridement.
Methods This study retrospectively analyzed 73 patients with thoracic and lumbar spinal tuberculosis who were treated using isolated posterior instrumentation without radical
debridement in our hospital between January 2012 to December 2019. The patient group was composed of 42 men and 31 women with a mean age of 67.3 ± 8.6 years. The tuberculosis spine
instability score (TSIS) was used to evaluate spine stability. All patients received chemotherapy for 18 months after surgery. The time of surgery, blood loss, visual analogue score (VAS),
kyphosis angle, Oswestry disability index (ODI), erythrocyte sedimentation rate (ESR), Frankel grading, SF-36 scores, and local recurrence and complications were analyzed to evaluate the
efficacy of isolated posterior instrumentation surgery in the treatment of thoracic and lumbar spinal tuberculosis.
Results All patients were followed up for 12 to 24 months (mean 14 ± 3.2 months). The mean surgical time was 1.2 ± 1.4 h (range, 1.2–1.6 h), and mean blood loss was 107 ± 18 mL. The
postoperative symptoms were obviously relieved. The VAS, kyphosis angle, DI, and ESR decreased, respectively, from 8.24 ± 1.32, 19.82 ± 3.42, 46.25 ± 3.62, and 49.64 ± 17.61 to 1.12 ± 0.21,
7.14 ± 0.81, 20.17 ± 5.11, and 0.35 ± 1.13 at final follow-up. In comparison to preoperative values, SF-36 scores were significantly improved at final follow-up and the differences were
statistically significant (p < 0.05). All patients achieved neurological recovery at the final follow-up. There were no recurrences or complications in any of the patients.
Conclusion Isolated posterior instrumentation without radical debridement is a suitable minor surgical trauma that offers a remarkable advantage of effective pain relief, improvement
in neurological function and performance status, and no local recurrence for selected patients with thoracic and lumbar spinal tuberculosis.
Funder
Hefei Municipal Natural Science Foundation
Natural Science Foundation of Anhui Province Universities
clinical research cultivation project of the second affiliated hospital of Anhui Medical University
Subject
Orthopedics and Sports Medicine,Surgery