One-stage posterior approach for treating multilevel noncontiguous thoracic and lumbar spinal tuberculosis

ABSTRACT

Objectives: Multilevel noncontiguous thoracic and lumbar spinal tuberculosis (MNST) is a relatively rare entity. The objective of this retrospective study was to investigate whether a technique involving a one-stage posterior debridement and decompression, combined with an intervertebral fusion and posterior instrumentation, is effective for treating MNST.

Methods: Thirteen patients, with an average age of 40.69 (18–67) years, who had MNST and were surgically treated in our department from January 2008 to October 2013, were reviewed.

Results: The average follow-up time was 37.54 ± 10.49 (19–58) months. The mean Cobb angle range was 15.69° ± 00A09.09° (−3° to 33°). The mean erythrocyte sedimentation rate (ESR) was 47.69 ± 9.30 mm/h (range 30–62 mm/h) before the operation. Neurological deficits were evaluated using the Frankel grade system. The mean Cobb angle decreased to 6.92° ± 3.93° postoperatively. Three months after the operation, the Cobb angle was 7.54° ± 4.35°, and the average ESR was 10.38 ± 4.54 mm/h that was normal for all cases in this retrospective observational study. Solid fusion was achieved in all cases. No severe complications occurred.

Conclusions: The study demonstrated that a one-stage posterior debridement and decompression, combined with an intervertebral fusion and posterior instrumentation, was effective for treating MNST.

KEYWORDS:

• Multilevel
• noncontiguous
• spinal tuberculosis
• surgical treatment
• decompression
• posterior
• fusion

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Writing assistance was utilized in the preparation of this manuscript, it was carried out by Biomedisys. Peer reviewers on this manuscript have no relevant financial relationships to disclose.

Additional information

Funding

Xiamen City Department of Trauma and Orthopaedics Key Specialist Construction Fund (NO: XiaWeiCai [2015] No. 465).