The Versatile Approach: A Novel Single Incision Combined with Anterior and Posterior Approaches for Decompression and Instrumented Fusion to Treat Tuberculosis of the Thoracic Spine

Sudhir Kumar Srivastava; Rishi Anil Aggarwal; Sunil Krishna Bhosale; Kunal Roy; Pradip Sharad Nemade

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자료유형: 학술저널

저자정보: Sudhir Kumar Srivastava (Seth G.S. Medical College and KEM Hospital) Rishi Anil Aggarwal (Seth G.S. Medical College and KEM Hospital) Sunil Krishna Bhosale (Seth G.S. Medical College and KEM Hospital) Kunal Roy (Seth G.S. Medical College and KEM Hospital) Pradip Sharad Nemade (Seth G.S. Medical College and KEM Hospital)

저널정보: 대한척추외과학회 Asian Spine Journal Asian Spine Journal Vol.11 No.2

발행연도: 2017.1

수록면: 294 - 304 (11page)

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Study Design: Retrospective case series. Purpose: To describe a novel single incision that combines anterior and posterior approaches for decompression and instrumented fusion to treat tuberculosis of the thoracic spine and study the neurological and radiological outcomes. Overview of Literature: Tuberculosis of the spine remains a major health issue in many developing countries. The options for treating tuberculosis of the thoracic spine include the anterior, posterior, and combined approaches, each with its advantages and disadvantages. Methods: Totally, 143 patients with tuberculosis of the thoracic spine were surgically treated using the “Versatile approach”. Posterior fixation was performed using sublaminar wires and a Hartshill rectangle in all patients. Anterior reconstruction was accomplished using bone graft harvested from autologous rib, iliac crest, or fibula. Results: The study included 45 males and 98 females, with a mean age of 33.18±18.65 years (range, 3–82 years) and a mean followup of 60.23±24.56 months (range, 18–156 months). Kyphosis improved from a mean value of 24.02 preoperatively to 10.25 postoperatively. A preoperative neurological deficit was observed in 131 patients, with 130 patients regaining ambulatory power. No patient had deterioration of neurological status following surgery. Fusion was achieved in all cases. The visual analogscale score improved from an average score of 7.02 preoperatively to 1.51 at final follow-up. Eight patients had superficial macerations, which healed spontaneously. One patient had buckling of the anterior graft, and one patient had implant breakage following road traffic accident. Conclusions: The “Versatile approach” is an effective, single-stage, single-incision method that combines anterior and posterior approaches for the surgically treating tuberculosis of the thoracic spine. It offers the advantage of direct visualization for decompression and reconstruction of the anterior and posterior vertebral columns, thus providing an excellent, long-lasting clinical outcome.

참고문헌 (2)

참고문헌 신청

Myung-Sang Moon / 2014 / Ossification of ligamentum flavum; Treatment; Prognostic factors / Asian Spine Journal 8(1):97~111

Jain AK / 2013 / Tuberculosis of spine: neurological deficit / Eur Spine J 22(Suppl 4):624~633

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