Abstract
Introduction
Tuberculosis of the dorsal spine is a very serious situation which may cause paraplegia and disability Purpose: We evaluated the clinical efficacy and feasibility of one –stage anterior debridement, internal fixation and interbody thoracic fusion in the treatment of single level thoracic tuberculosis.Materials and Methods: Forty three adult patients (mean age: 49.5-years) fixed with Z-plate by anteriortransthoracic-transpleural approach. Assessment was done using Frankel classification, blood-loss, operative-time, Cobb-angle, correction loss, union and Oswestry disability index (ODI).
Results
All cases were followed up for 48.5 weeks on average. Average mean operative time was 167 min, evaluated blood loss during surgery 1015 ml, rate of kyphosis correction79.2%, loss of corrected angle 0.8 ± 1.2° and Cobb-angle improved from 36.6 ± 8.4° to 7.5 ± 2.3°. Postoperative Cobb-angles were significantly better than preoperative ones. ODI was 3.4 ± 4.1. All patients achieved union with 100% cure rate. All but one patient achieved full neurological recovery. No severe complications or spinal cord injury occurred. Superficial infection. Occurred in one case. Lung parenchymal injury in two case and DVT in one case.
Conclusions
This approach can directly and successfully remove the focus of tuberculosis and give very good union and kyphosis correction rate that were maintained overtime.