Background And Objectives: The treatment of thoracic/thoracolumbar spinal tuberculosis (STB) remains challenging. The spinal deformity, long disease history, heterogeneous lesion, and poor drug response make the treatment of recurrent and kyphosis cases even more difficult. This study aims to investigate the efficacy and safety of single-posterior revision surgery in patients with recurrent thoracic/thoracolumbar STB and kyphosis.
Methods: Patients with recurrent thoracic/thoracolumbar STB with kyphosis and treated with single-posterior debridement, osteotomy, correction, bone graft, and fusion in our center from 2009 to 2019 were enrolled. The clinical data, radiographs, and erythrocyte sedimentation rate (ESR) at different stages were collected. ESR, kyphotic angle, Visual Analog Scale, and neurological functions were analyzed.
Results: A total of 27 patients (16 male, 11 female) with an average age of 48.4 ± 13.0 years were included. The average surgery time was 320.6 ± 46.4 minutes, and the average estimated blood loss was 1470.6 ± 367.4 mL. From admittance to the latest follow-up, the average Visual Analog Scale significantly reduced from 5.6 ± 1.3 to 0.5 ± 0.7, the average ESR was improved from 69.4 ± 15.8 mm/h to normal, and the average kyphotic angle was corrected from 66.6° ± 11.7° to 34.5° ± 6.6°. For patients with preoperative neurological deficits, their neurological functions were improved to normal. In drug susceptibility tests, 70.5% (11/17) of specimens had bacteria resistant to at least 1 first-line drug.
Conclusion: Single-posterior debridement, osteotomy, correction, bone graft, and fusion are effective and safe in the treatment of recurrent thoracic/thoracolumbar spinal tuberculosis with kyphosis. The drug treatment of recurrent spinal tuberculosis should be carefully tailored.
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http://dx.doi.org/10.1227/ons.0000000000000702 | DOI Listing |
World Neurosurg
December 2023
Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran; Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Electronic address:
Objective: Spinal ganglioneuromas (GNs) are rare benign tumors that often manifest as symptoms related to the compression of neural elements. The preferred treatment for affected patients is surgical resection, which typically improves symptoms and accompanies a low likelihood of tumor recurrence. We conducted a systematic review of reports of GNs involving the spinal cord and nerve roots, examining their clinical presentation, surgical management, and outcomes.
View Article and Find Full Text PDFOper Neurosurg (Hagerstown)
July 2023
Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, China.
Background And Objectives: The treatment of thoracic/thoracolumbar spinal tuberculosis (STB) remains challenging. The spinal deformity, long disease history, heterogeneous lesion, and poor drug response make the treatment of recurrent and kyphosis cases even more difficult. This study aims to investigate the efficacy and safety of single-posterior revision surgery in patients with recurrent thoracic/thoracolumbar STB and kyphosis.
View Article and Find Full Text PDFJ Neurosurg Spine
March 2013
Departments of Neurological Surgery, University of California, SanFrancisco, CA 94117 USA.
Object: Ependymomas are primary central nervous system tumors that occur more frequently in the spines of adults than they do there in children. Previous studies consist mainly of retrospective single-institutional experiences or case studies. In this study, a comprehensive literature review was performed on reported cases of spinal ependymoma treated with resection to determine whether tumor location along the spinal axis conveys important prognostic information.
View Article and Find Full Text PDFZhonghua Yi Xue Za Zhi
January 2003
Department of Spinal and Orthopaedic Surgery, Nanfang Hospital, The First Military Medical University, Guangzhou 510515, China.
Objective: To evaluate the clinical efficacy of one-stage surgical management for spinal tuberculosis.
Methods: Fifty-seven patients with thoracic, thoracolumbar and lumbar spinal tuberculosis were treated surgically by a single stage procedure from Jan 1996 to Jan 2001, including anterior resection, interbody outografting and anterior instrumentation in 35 cases, posterior debridement and posterior instrumentation in 16 cases, and posterior instrumentation and anterior resection plus interbody autografting in 6 cases. Titanium-alloy spinal implants were used in 38 cases and stainless steel implants in other 19 cases.
Spine (Phila Pa 1976)
October 1993
Department of Orthopaedic Surgery, Faculty of Medicine, Kyushu University, Japan.
The risk of persistence and recurrence of infection in posterior spinal instrumentation surgery for spinal tuberculosis was studied clinically and microbiologically. Eleven patients with thoracic, thoracolumbar, and lumbar spinal tuberculosis treated by debridement, anterior fusion, and combined posterior instrumentation surgery were analyzed. Seven patients had tuberculosis in both anterior and posterior spinal elements.
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