The operative option and therapeutic effect in the treatment of multiple-level contiguous thoracic spinal tuberculosis

Objective To investigate operative approach,immobilization manner,and surgical effect of multiple-level contiguous thoracic spinal tuberculosis.Methods Between January 2001 and December 2010,112 patients with thoracic spinal tuberculosis were treated with 5 different surgical procedures.Among them,81 adults with multiple-level contiguous thoracic spinal tuberculosis were followed up for 17 to 75 months (average,39 months).Twenty three patients suffered from spinal cord dysfunction; according to the Frankel classification,there were 3 cases of type A,4 cases of type B,7 cases of type C,and 9 cases of type D.The double vertebral bodies were commonly affected areas,especially T10 and T11-Results Local symptoms of all patients were relieved significantly 1 to 3 weeks postoperatively.Erythrocyte sedimentation rates (ESR) returned to normal level in all patients 8 to 12 weeks postoperatively.Three sinuses were found 0.5 month,1 month and 1.5 months postoperatively,respectively,which were cured by changing dressing for 1 to 2 months.The average correction of kyphotic deformity was 10.2°±2.1° in anterior fixation group,while 12.6°±2.7° in posterior fixation group.At final follow-up,the average loss of correction was 6.9°±1.9° in anterior fixation group,while 5.8°±1.4° in posterior fixation group.At least one Frankel grade improvement was observed in 23 patients.Conclusion The surgical methods should be chosen according to the location and degree of the lesion.Correct surgical procedures can obtain good results in correction and maintenance of the deformity,clearance of the foci,decompression of the spinal cord and pain relief for thoracic spinal tuberculosis.The posterior fixation is better than the anterior fixation with regard to correction and maintenance of the kyphotic deformity. Key words: Thoracic vertebrae;  Tuberculosis, spinal;  Spinal fusion