Anterior debridement and reconstruction via thoracoscopy-assisted mini-open approach for the treatment of thoracic spinal tuberculosis: minimum 5-year follow-up

作者：Lu, Guohua; Wang, Bing^*; Li, Jing; Liu, Weidong; Cheng, Ivan

来源：European Spine Journal, 2012, 21(3): 463-469.

DOI：10.1007/s00586-011-2038-5

• Spinal thoracic vertebrae
• Thoracoscopy
• Tuberculosis

Video-assisted thoracoscopic surgery (VATS) has been developed for surgical treatment of thoracic spinal tuberculosis to overcome the problems associated with a formal thoracotomy. VATS, however, is technically demanding with a difficult learning curve. @@@ We conducted a retrospective long-term follow-up study of anterior debridement and reconstruction via a thoracoscopy-assisted mini-open approach for the surgical treatment of thoracic spinal tuberculosis. There were 50 patients collected with mean age 38.3 years with thoracic spinal tuberculosis. @@@ The average operative time was 210 min (range 170-300 min), the average blood loss during operation was 550 ml (range 300-1,000 ml), and the mean chest drainage duration was 3.5 days (3-5 days). Complications occurred in 17 patients (34%). The mean follow-up was 6.5 years. There was statistically difference in VAS 3 months after surgery compared to preoperatively (P < 0.001), as well as final follow-up compared to 3 months post-op (P < 0.001). In patients with minor pulmonary impairment as measured by pulmonary function testing, 15 improved to normal and 5 had no change. In patients with moderate pulmonary impairment, 6 improved to normal and 2 improved to minor impairment at final follow-up. Neurological improvement of one to three grades had occurred in 26 patients by final follow-up. There was statistically difference in kyphotic angle 3 months after surgery compared to preoperatively (P < 0.05), as well as final follow-up compared to 3 months post-op (P < 0.001). The average correction rate of kyphotic angle was 38.7% and the loss of correction rate was 1.3% at final follow-up. No recurrent tuberculosis was found. @@@ Thoracoscopy-assisted mini-open approach can provide a simple, safe, and practical treatment option with minimal invasiveness in cases of thoracic spinal tuberculosis. Successful clinical and radiographic outcomes can be achieved via anterior debridement and reconstruction at long-term follow-up.

• 出版日期2012-3
• 单位中南大学