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, 20 (1), 95

Single-stage Posterior Debridement, Decompression and Transpedicular Screw Fixation for the Treatment of Thoracolumbar Junction (T12-L1) Tuberculosis With Associated Neurological Deficit: A Multicentre Retrospective Study

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Single-stage Posterior Debridement, Decompression and Transpedicular Screw Fixation for the Treatment of Thoracolumbar Junction (T12-L1) Tuberculosis With Associated Neurological Deficit: A Multicentre Retrospective Study

Yanping Zeng et al. BMC Musculoskelet Disord.

Abstract

Background: A multicentre retrospective study was conducted to evaluate the safety and efficacy of single-stage posterior debridement, decompression and transpedicular screw fixation for the treatment of thoracolumbar junction (T12-L1) tuberculosis in patients with associated neurological deficit.

Methods: Thoracolumbar junction (T12-L1) tuberculosis patients (n = 69) with neurological deficit who underwent single-stage posterior debridement, decompression and transpedicular screw fixation from January 2005 to January 2015 were included in the study. Antituberculosis therapy was performed both before and after surgery. The surgery duration and patient blood loss were evaluated, in addition to the change in pain visual analogue score (pVAS), kyphotic angle, Oswestry disability index (ODI) score and American Spinal Injury Association (ASIA) grade assessed preoperatively, immediate postoperatively and at the final follow-up visit.

Results: The average blood loss was 354 ± 291 mL. The average kyphosis angle was corrected from 21 ± 9° preoperatively to 9 ± 4° postoperatively, with a mean decrease in pVAS and ODI scores of 3.4 and 16, respectively. The postoperative ASIA grading was grade A for five patients, grade C for 15 and grade D for 49 patients, which had improved to grade C for four patients, grade D for three patients and grade E for 62 patients at the final follow-up. The neurological deficit did not worsen in any of the patients.

Conclusions: Single-stage posterior debridement, decompression and transpedicular screw fixation is an effective treatment method in thoracolumbar junction (T12-L1) tuberculosis patients with neurological deficit, with good neurological recovery and no progression of kyphosis.

Keywords: Neurological deficit; Posterior decompression; Spinal tuberculosis; Thoracolumbar junction.

Conflict of interest statement

Ethics approval and consent to participate

The research was approved by the Ethics Committee of the First Affiliated Hospital of the Third Military Medical University, People’s Liberation Army (PLA). All participants have been informed and gave written consent prior to data collection.

Consent for publication

Not Applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Single-stage posterior debridement, decompression and transpedicular screw fixation of a 35-year-old woman with thoracolumbar junction tuberculosis with associated neurological deficit. (a, b) Preoperative lateral and anteroposterior X-rays; (c) preoperative computed tomography (CT); (d) preoperative MRI; (e) X-ray at 3 days postoperative; (f) CT scan at 12 months postoperative; (i) MRI at 12 months postoperative; and (g) 3D reconstruction of CT at 12 months postoperative.

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