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Gan J, Zhang C, Tang D, Du X. Surgical treatment of spinal tuberculosis: an updated review. Eur J Med Res 2024; 29:588. [PMID: 39695719 DOI: 10.1186/s40001-024-02198-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 12/04/2024] [Indexed: 12/20/2024] Open
Abstract
Tuberculosis (TB) is a worldwide disease which seriously affects the global public health. Spinal TB is the most common extra-pulmonary TB and may cause vertebral bone destruction, collapse, kyphosis and even paralysis. Anti-TB chemotherapy is considered the cornerstone treatment of spinal TB and surgery is often required for patients with severe kyphosis, impaired neurological function or spinal instability. Debridement of TB lesions, bone grafting and internal fixation are the key procedures of spinal TB surgery. However, the selection of surgical approach, the extent of TB lesion debridement, the choice of bone graft materials, and the method and extent of internal fixation are all remain controversy. The aim of this updated review is to evaluate current literature for advances in management of spinal TB, with particular focus on surgical techniques.
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Affiliation(s)
- Jinjing Gan
- Department of Orthopedics, Chongqing Traditional Chinese Medicine Hospital, Chongqing, 400021, China
| | - Chuanzhi Zhang
- Department of Orthopedics, Chongqing Traditional Chinese Medicine Hospital, Chongqing, 400021, China
| | - Dagang Tang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 YouYi Road, Yuanjiagang, Yu Zhong District, Chongqing, 400016, China
- Chongqing Municipal Health Commission Key Laboratory of Musculoskeletal Regeneration and Translational Medicine, Chongqing, 400016, China
- Orthopaedic Research Laboratory of Chongqing Medical University, Chongqing, 400016, China
| | - Xing Du
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 YouYi Road, Yuanjiagang, Yu Zhong District, Chongqing, 400016, China.
- Chongqing Municipal Health Commission Key Laboratory of Musculoskeletal Regeneration and Translational Medicine, Chongqing, 400016, China.
- Orthopaedic Research Laboratory of Chongqing Medical University, Chongqing, 400016, China.
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Liu Z, Xu Z, Zhang Y, Wang X, Zhang Z, Jiang D, Jia R. Endoscopy-assisted anterior cervical debridement combined with posterior fixation and fusion for the treatment of upper cervical spine tuberculosis: a retrospective feasibility study. BMC Musculoskelet Disord 2022; 23:126. [PMID: 35135516 PMCID: PMC8827151 DOI: 10.1186/s12891-022-05084-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/03/2022] [Indexed: 02/06/2023] Open
Abstract
Background This retrospective study aimed to determine the feasibility and efficacy of endoscopy-assisted anterior cervical debridement combined with posterior fixation and fusion in patients with upper cervical spine tuberculosis. Methods Between June 2008 and January 2016, 17 patients (10 men and 7 women) with upper cervical spine tuberculosis underwent endoscopy-assisted anterior cervical debridement combined with posterior fixation and fusion. Anti-tuberculosis treatment was administered for 2–4 weeks preoperatively and 12–18 months postoperatively. The clinical and radiographic data of the patients were analyzed. Results The operation was successfully completed in all patients. Neck pain and stiffness were relieved after the surgery in all patients. The mean operation time was 210.0 ± 21.2 min, and the mean intraoperative blood loss was 364.7 ± 49.6 mL. The mean follow-up duration was 68.1 ± 6.7 months. The erythrocyte sedimentation rate returned to normal by 3 months postoperatively. Visual analog scale scores for neck pain were significantly lower postoperatively than preoperatively. All patients had significant postoperative neurological improvement. Patient-reported outcomes, as measured using the Kirkaldy-Willis criteria, were as follows: excellent, 12 patients; good, 4 patients; fair, 1 patient; and poor, 0 patients. Bone fusion was achieved at 10.9 ± 1.9 months after the surgery; no cases of instrument loosening or fracture occurred. Conclusion Endoscopy-assisted anterior cervical debridement combined with posterior fixation and fusion is a feasible and effective surgical method for the treatment of upper cervical spine tuberculosis. It can be used to restore upper cervical spine stability and facilitate spinal healing.
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Affiliation(s)
- Zheng Liu
- Hunan Children's Hospital, 86# Ziyuan Road, Changsha, 410007, Hunan, China
| | - Zhenchao Xu
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, 410008, Hunan, China. .,Hunan Engineering Laboratory of Advanced Artificial Osteo-Materials, 87# Xiangya Road, Changsha, 410008, Hunan, China.
| | - Yilu Zhang
- Hunan Engineering Laboratory of Advanced Artificial Osteo-Materials, 87# Xiangya Road, Changsha, 410008, Hunan, China
| | - Xiyang Wang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, 410008, Hunan, China.,Hunan Engineering Laboratory of Advanced Artificial Osteo-Materials, 87# Xiangya Road, Changsha, 410008, Hunan, China
| | - Zhen Zhang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, 410008, Hunan, China.,Hunan Engineering Laboratory of Advanced Artificial Osteo-Materials, 87# Xiangya Road, Changsha, 410008, Hunan, China
| | - Dingyu Jiang
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, 410008, Hunan, China.,Hunan Engineering Laboratory of Advanced Artificial Osteo-Materials, 87# Xiangya Road, Changsha, 410008, Hunan, China
| | - Runze Jia
- Department of Spine Surgery and Orthopaedics, Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, 410008, Hunan, China.,Hunan Engineering Laboratory of Advanced Artificial Osteo-Materials, 87# Xiangya Road, Changsha, 410008, Hunan, China
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