Issue release date: 08.03.2024
2Stanford University, Department of Orthopaedic Surgery, Stanford, USA DOI : 10.5137/1019-5149.JTN .4639-11.1 AIM: To evaluate the long-term outcomes for the surgical treatment of thoracic and thoracolumbar spinal tuberculosis with anterior radical debridement and reconstruction with titanium mesh cages (TMCs).
MATERIAL and METHODS: 69 patients with thoracic and thoracolumbar spinal tuberculosis were retrospectively analyzed. Outcomes data included VAS back pain, subjective clinical results, and radiographic data.
RESULTS: All patients had resolution of their infections, obtained solid bony fusions without failure of fixation, experienced improvement of neurological function, and improved in their VAS back pain scores at final long-term follow-up. In the thoracic spine group, 92.3% of patients had good or excellent subjective clinical results. The loss of kyphotic angle correction and intervertebral height was 9.6% and 3.8%, respectively. In the thoracolumbar spine group, 93.3% of patients had good or excellent subjective clinical results. The loss of kyphotic angle correction and intervertebral height was 12.8% and 4.2%, respectively.
CONCLUSION: Anterior radical debridement and reconstruction using TMCs for the treatment of thoracic and thoracolumbar spinal tuberculosis is an acceptable treatment option. Solid bony fusion, good clinical outcomes as well as improvement of neurological function can be achieved although TMCs subsidence can occur.
Keywords : Thoracic spine, Thoracolumbar spine, Tuberculosis, Debridement, Titanium mesh cage, Fixation