【摘 要】
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Aim: The aim of this retrospective clinical study is to evaluate the long-term outcomes for single-stage transpedicular debridement,posterior instrumentation and fusion in the management of thoracic a
【机 构】
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Department of Spine Surgery, Xiangya Hospital of Central South University, Changsha, Hunan, China
【出 处】
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第三届全国脊柱结核诊疗新技术研讨会暨2017年湖南省医学会脊柱外科专业委员会年会
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Aim: The aim of this retrospective clinical study is to evaluate the long-term outcomes for single-stage transpedicular debridement,posterior instrumentation and fusion in the management of thoracic and thoracolumbar spinal tuberculosis in adults.Methods: Fifty-nine adult patients with thoracic and thoracolumbar spinal tuberculosis underwent single-stage transpedicular debridement,posterior instrumentation and fusion.These patients were followed for a minimum of S years.Patients were assigned to one of two groups according to the infected anatomic seg-ment.In the thoracic spinal tuberculosis group,there were 28 cases (17 males,11 females) with a mean age of 38.9 years;in the thoracolumbar spinal tuberculosis group,there were 31 cases (19 males,12 females) with a mean age of 40.3 years.All cases were evaluated clinically using the visual analog scale (VAS),Kirkaldy-Willis criteria and the American Spinal Injury Association (ASIA) impairment scale.Radiographs were performed for measuring the angle of kyphosis and scoliosis.Complications related to surgery were recorded.Results: All patients successfully resolved their infections,experienced one or more ASIA grades of improvement,and improved in their VAS pain scores at final follow-up.In both groups,patient-reported outcomes reached over 9096 excellent or good results using Kirkaldy-Willis criteria.The loss of kyphotic angle correction was 2.6° in the thoracic spinal tuberculosis group and 32° in the thoracolumbar spinal tuberculosis group.No scoliosis was observed in either group.Fifty-eight (983%) cases achieved solid bony fusion.In the thoracolumbar spinal tuberculosis group,one patient experienced screw loosening,and another patient with nonunion and rod breakage underwent revision surgery.Conclusions: The technique of single-stage transpedicular debridement,posterior instrumentation and fusion is an effective method for the treatment of thoracic and thoracolumbar spinal tuberculosis in adults.Long-term postoperative clinical and radiological outcomes were satisfactory.
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