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One-stage posterior transpedicular debridement, hemi-interbody and unilateral-posterior bone grafting, and instrumentation for the treatment of thoracic spinal tuberculosis: a retrospective study

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Abstract

Purpose

To investigate the clinical efficacy and feasibility of the surgical treatment of thoracic spinal tuberculosis using one-stage posterior instrumentation, transpedicular debridement, and hemi-interbody and unilateral posterior bone grafting.

Methods

Fifty-six patients with thoracic spinal tuberculosis who underwent surgery performed by a single surgeon between September 2009 and August 2020 were enrolled in this study. Based on data from the erythrocyte sedimentation rate (ESR), Visual Analog Scale (VAS), and Cobb angle before surgery, after surgery, and at the most recent follow-up, clinical effectiveness was assessed using statistical analysis. The variables investigated included operating time, blood loss, complications, neurological function, and hemi-interbody fusion.

Results

None of the patients experienced significant surgery-associated complications. At the last follow-up, 23 of the 25 patients (92%) with neurological impairment showed improvement. The thoracic kyphotic angle was significantly decreased from 24.1 ± 9.9° to 13.4 ± 8.6° after operation (P < 0.05), and the angle was 14.44 ± 8.8° at final follow-up (P < 0.05). The Visual Analog Scale significantly decreased from 6.7 ± 1.4 preoperatively to 2.3 ± 0.8 postoperatively (P < 0.05) and finally to 1.2 ± 0.7 at the last follow-up (P < 0.05). Bone fusion was confirmed in 56 patients at 3–6 months postoperatively.

Conclusions

One-stage posterior transpedicular debridement, hemi-interbody and unilateral posterior bone grafting, and instrumentation are effective and feasible treatment methods for thoracic spinal tuberculosis.

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Data availability

The data that supports the findings of this study are available on request from the corresponding author. The data is not publicly available due to privacy or ethical restrictions.

Code availability

Not available.

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Author notes

  1. Yan Liu, Qingshan Liu, and Xuzhou Duan contributed equally.

Authors and Affiliations

  1. Department of Orthopedics, Shanghai Changhai Hospital, 168 Changhai Road, Shanghai, 200433, People’s Republic of China

    Yan Liu, Qingshan Liu, Xuzhou Duan, Wentao Wang, Lianjie Pu, Beier Luo & Dawei He

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Contributions

Conceptualization: Yan Liu.

Formal Analysis: Lianjie Pu

Investigation: Qingshan Liu, Xuzhou Duan, and Wentao Wang.

Methodology: Beier Luo.

Project administration: Beier Luo and Dawei He.

Writing original draft: Yan Liu.

Writing, review, and editing: Dawei He.

Corresponding author

Correspondence to Dawei He.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Changhai Hospital (2022–10-25/CHEC2022-204).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Consent for publication

The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1, 2, and 3.

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The authors declare no competing interests.

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Liu, Y., Liu, Q., Duan, X. et al. One-stage posterior transpedicular debridement, hemi-interbody and unilateral-posterior bone grafting, and instrumentation for the treatment of thoracic spinal tuberculosis: a retrospective study. Acta Neurochir 166, 65 (2024). https://doi.org/10.1007/s00701-024-05966-7

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