Lei Shuanhu, Zhou Jianwei, Guo Li, Guan Xiaoli, Zhang Mingtao, Yue Haiyuan, Kang Xuewen
Department of Orthopedics, The Second Hospital of Lanzhou University, Lanzhou, 730030, China.
Orthopaedics Key Laboratory of Gansu Province, The Second Hospital of Lanzhou University, Lanzhou, 730030, China.
Heliyon. 2024 Oct 16;10(23):e39435. doi: 10.1016/j.heliyon.2024.e39435. eCollection 2024 Dec 15.
Thoracic spinal tuberculosis (TB) is still common, and surgical treatment can rapidly relieve pain, correct deformity, reduce bone loss and prevent further damage to neurological function. We have practiced an efficient and safe surgical method.
From January 2013 to April 2021, 38 patients with thoracic spinal TB were included in our study. Debridement and bone grafting were performed via the lateral extracavitary approach, combined with two different fixation methods. Data from these cases were analyzed retrospectively.
For all cases, the C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) of all the patients decreased to normal levels at the last follow-up. The average visual analog scale (VAS) score was 7.5 ± 1.6 preoperatively and 0.6 ± 0.8 at the last follow-up, showing a significant reduction. The average angle of kyphosis correction was 6.3 ± 4.7°, and the loss of correction was 1.4 ± 1.6°. Neurological function was significantly improved in all cases according to the American Spinal Injury Association (ASIA) classification. Solid fusion was observed in all cases at the last follow-up.
Debridement and bone graft fusion via the lateral extracavitary approach combined with two fixation methods can be very effective in the treatment of thoracic spinal TB.
胸椎结核仍然常见，手术治疗可迅速缓解疼痛、矫正畸形、减少骨质流失并防止神经功能进一步受损。我们实践了一种高效且安全的手术方法。
2013年1月至2021年4月，38例胸椎结核患者纳入本研究。通过外侧腔外入路进行清创和植骨，并结合两种不同的固定方法。对这些病例的数据进行回顾性分析。
所有病例在末次随访时，所有患者的C反应蛋白（CRP）水平和红细胞沉降率（ESR）均降至正常水平。术前平均视觉模拟评分（VAS）为7.5±1.6，末次随访时为0.6±0.8，显著降低。平均后凸矫正角度为6.3±4.7°，矫正丢失为1.4±1.6°。根据美国脊髓损伤协会（ASIA）分类，所有病例的神经功能均有显著改善。末次随访时所有病例均观察到牢固融合。
外侧腔外入路清创植骨融合结合两种固定方法在胸椎结核治疗中非常有效。
