Single-stage posterior instrumentation and anterior debridement for active tuberculosis of the thoracic and lumbar spine with kyphotic deformity

Wang, Xiaobin; Li, Jing; Li, Guohua; Wang, Bin; Lu, Chin‐Song; Kang, Yijun

doi:10.1007/s00264-011-1389-1

Cited by 41 publications

(28 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Following the advent of modern spinal instrumentation systems, several authors have reported combined anterior and posterior fusion either as a single-stage or as a twostage procedure following the initial description of the procedure by Yau et al [12][13][14][15][16][17][18][19][20][21][22][23] in 1974. Earlier apprehensions regarding the use of metal implants in the presence of active tubercular infection were overcome following the realization that tubercle bacilli had slow rates of division, lower bacillary counts than pyogenic infections, and do not produce adhesion molecule and bio-film [24,25].…”

Section: Discussionmentioning

confidence: 99%

Isolated posterior instrumentation for selected cases of thoraco-lumbar spinal tuberculosis without anterior instrumentation and without anterior or posterior bone grafting

Kumar¹,

Joseph²,

Manur³

2012

Eur Spine J

View full text Add to dashboard Cite

Purpose The aim of this prospective study is the analysis of the clinical and radiological outcomes of active thoracolumbar spinal tuberculosis treated with isolated posterior instrumentation without any posterior bone grafting or anterior inter-body bone grafting or anterior instrumentation. Methods The study was a prospective follow-up of 25 patients with active thoraco-lumbar spinal tuberculosis who underwent posterior spinal instrumentation with pedicle screws and rods. These patients had posterior stabilization of the involved segment of the spine without anterior or posterior bone grafting. The mean duration of follow-up was 3.3 years and the minimum duration of follow-up was 2 years. Results The mean kyphotic angle improved from 32.4°p re-operatively to 7.2°in the early follow-up period. Following a minor loss of correction during follow-up, the mean kyphotic angle settled at 11.5°at the time of final follow-up. Inter-body bony fusion was noticed at the final follow-up in all patients despite the absence of anterior bone grafting or cages. Conclusion Posterior instrumented stabilization followed by chemotherapy seems to be adequate for obtaining satisfactory healing of the lesions. Anterior inter-body bony arthrodesis occurs despite the absence of anterior bone grafts or cages. Careful patient selection is critical for successful outcome with this technique.

show abstract

Section: Discussionmentioning

confidence: 99%

Isolated posterior instrumentation for selected cases of thoraco-lumbar spinal tuberculosis without anterior instrumentation and without anterior or posterior bone grafting

Kumar¹,

Joseph²,

Manur³

2012

Eur Spine J

View full text Add to dashboard Cite

show abstract

“…This technique has high infection resolution rates, ability to eradicate paravertebral abscess and achieve vertebral fusion in 97% of cases [2]. Additionally, surgery has the advantage to control spinal deformity and limits or improves the neurological injury resulting from this disease [9,10].…”

Section: Discussionmentioning

confidence: 99%

Extensive Involvement of the Dorsal Spine by Tuberculous Infection and Surgical Treatment with Percutaneous Spinal Instrumentation

Brito¹

2014

J Infect Dis Ther

View full text Add to dashboard Cite

Purpose: Tuberculosis can be responsible for extensive spinal lesions. Despite the efficacy of medical treatment surgery is indicated to avoid or correct significant deformity, instability and neurological involvement.The authors present a clinical case of total dorsal spine involvement with posterior and anterior major abscess, discussing the management options and outcome obtained.Clinical case: 24 years old male patient, admitted with severe dorsal pain and fluctuating posterior left hemithorax mass with no neurological impairment. CT-Scan and MRI showed extensive lytic lesions from T2 to T12 with gross instability in T8-T9.The patient was surgically treated after 15 days of antibiotic therapy, having a continuous drainage from the left posterior hemithorax superinfected with Staphylococcus aureus. A posterior percutaneous unilateral T5-T12 pedicular instrumentation plus anterior debridement and T7-T10 arthrodesis with vascularized rib graft was performed. Left pedicular instrumentation was postponed to the third week to allow healing of the superinfected area over the left hemithorax where skin was all detached from rib cage. At 24 months follow up, the patient regained complete and normal functional activity with no recurrence of infection, showing a solid fusion over the thoracic area with no deformity.Discussion: Extensive involvement and pyogenic abscess superinfection makes this case a significant therapeutic challenge. In our opinion, anterior-posterior surgery and staged posterior percutaneous instrumentation were favourable related with the excellent outcome.

show abstract

“…In contrast to the study by Moon et al (11), we excluded patients with severe kyphosis to make the baseline of patients more similar to yield a more accurate comparison between surgery and nonsurgery groups. Even after TB was cured by chemotherapy, kyphosis could progress, and it could lead to delayed paralysis for patients treated conservatively (16,18). Jain and Jain (8) also concluded that panvertebral disease and long-segment disease including kyphosis correction should be indications for instrumented stabilization.…”

Section: Prognostic Factorsmentioning

confidence: 96%

Clinical Characteristics and Neurologic Recovery of Patients with Cervical Spinal Tuberculosis: Should Conservative Treatment Be Preferred? A Retrospective Follow-Up Study of 115 Cases

Jian¹,

Jiang²,

et al. 2015

World Neurosurgery

View full text Add to dashboard Cite

Single-stage posterior instrumentation and anterior debridement for active tuberculosis of the thoracic and lumbar spine with kyphotic deformity

Abstract: Objective The purpose of this study was to validate the efficacy and safety of single-stage posterior instrumentation and anterior debridement for treatment of active spinal tuberculosis with kyphotic deformity.

Cited by 41 publications

References 28 publications

Isolated posterior instrumentation for selected cases of thoraco-lumbar spinal tuberculosis without anterior instrumentation and without anterior or posterior bone grafting

Isolated posterior instrumentation for selected cases of thoraco-lumbar spinal tuberculosis without anterior instrumentation and without anterior or posterior bone grafting

Extensive Involvement of the Dorsal Spine by Tuberculous Infection and Surgical Treatment with Percutaneous Spinal Instrumentation

Clinical Characteristics and Neurologic Recovery of Patients with Cervical Spinal Tuberculosis: Should Conservative Treatment Be Preferred? A Retrospective Follow-Up Study of 115 Cases

Contact Info

Product

Resources

About