EFFECTIVENESS AND SAFETY ASSESSMENTS OF THORACOSCOPIC THORACIC TUBERCULOSIS CLEARANCE AND INTERNAL FIXATION WITH BONE GRAFTING SUPPORTED BY DIGITAL TECHNOLOGY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 LIULimin , SONGYueming , GONGQuan , ZHOUChunguang , ANYonggang

Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P. R. China;

Corresponding author：

LIULimin, Email: 18980601394@163.com

Keywords：

Thoracoscope; Thoracic tuberculosis; Digital technology; Debridement; Internal fixation

DOI：

10.7507/1002-1892.20140015

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the effectiveness and safety of treatment of thoracic tuberculosis with thoracoscope supported by digital technology. Methods Between June 2010 and February 2012, 11 patients with thoracic tuberculosis were treated and the clinical data were retrospectively analyzed. There were 7 males and 4 females with an average age of 23.6 years (range, 16-47 years) and an average disease duration of 16 months (range, 6-18 months). Two vertebral bodies and one intervertebral space were involved at T_6-11. At preoperation, the neurologic function degree was classified as Frankel grade E. Three dimensional reconstruction of thorax and spine and surgical procedure design (including focal clearance, bone grafting, and screw fixation) were done at SUPERIMAGE workstation. Surgery procedures were conducted following the preoperative designs. Results The operative procedures were consistent with preoperative designs. All of these operations were successfully performed. The mean time of operation was 146 minutes (range, 120-180 minutes); the mean blood loss was 120 mL (range, 100-150 mL); the mean indwelling time of closed thoracic drainage was 38 hours (range, 24-48 hours); and the mean hospitalization time was 4.6 days (range, 3-5 days). Eleven patients were followed up 12-25 months (mean, 16 months). No complication of nerve damage, incision pain and infection, or pulmonary infection was observed. Rigid fixation and born fusion were obtained at last follow-up; no obvious change of thoracic vertebral alignment was detected and no internal fixation failure occurred. Conclusion It is a minimally invasive, effective, and safe method to treat thoracic tuberculosis with thoracoscope supported by digital technology.

Citation： LIULimin, SONGYueming, GONGQuan, ZHOUChunguang, ANYonggang. EFFECTIVENESS AND SAFETY ASSESSMENTS OF THORACOSCOPIC THORACIC TUBERCULOSIS CLEARANCE AND INTERNAL FIXATION WITH BONE GRAFTING SUPPORTED BY DIGITAL TECHNOLOGY. Chinese Journal of Reparative and Reconstructive Surgery, 2014, 28(1): 64-68. doi: 10.7507/1002-1892.20140015 Copy

1.	陈云生,游辉,陈荣春,等.胸腔镜辅助下前路病灶清除植骨内固定治疗胸椎结核.中国矫形外科杂志,2011,19(3):184-187.
2.	彭明,戚超,曹新峰,等.胸腔镜辅助下前路一期病灶清除及植骨内固定术治疗胸椎结核.中国修复重建外科杂志,2010,24(11):1405-1406.
3.	陈玉兵,陆声,徐永清,等.数字化导航模板辅助胸椎椎弓根螺钉置钉实验研究.中国骨科临床与基础研究杂志,2010,2(2):125-129.
4.	吕国华,王冰,李晶,等.胸腔镜辅助小切口胸椎结核前路重建手术的临床研究.中华医学杂志,2006,86(43):3043-3046.
5.	Wang Z,Shi J,Geng G,et al.Ultra-short-course chemotherapy for spinal tuberculosis:five years of observation.Eur Spine J,2013,22(2):274-281.
6.	Wang Z,Wu Q,Geng G.Anterior debridement and bone grafting with posterior single-segment internal fixation for the treatment of mono-segmental spinal tuberculosis.Injury,2013,44(2):253-257.
7.	Wang B,Lv G,Liu W,et al.Anterior radical debridement and reconstruction using titanium mesh cage for the surgical treatment of thoracic and thoracolumbar spinal tuberculosis:minimium five-year follow-up.Turk Neurosurg,2011,21(4):575-581.
8.	Zhang H,Sheng B,Tang M,et al.One-stage surgical treatment for upper thoracic spinal tuberculosis by internal fixation,debridement,and combined interbody and posterior fusion via posterior-only approach.Eur Spine J,2013,22(3):616-623.
9.	Rigotti S,Boriani L,Luzi CA,et al.Minimally invasive posterior stabilization for treating spinal tuberculosis.J Orthop Traumatol,2013,14(2):143-145.
10.	Zhang HQ,Li JS,Zhao SS,et al.Surgical management for thoracic spinal tuberculosis in the elderly:posterior only versus combined posterior and anterior approaches.Arch Orthop Trauma Surg,2012,132(12):1717-1723.
11.	Tuli SM.Historical aspects of Pott's disease (spinal tuberculosis) management.Eur Spine J,2013,22 Suppl 4:529-538.
12.	Kaloostian PE,Gokaslan ZL.Current management of spinal tuberculosis:a multimodal approach.World Neurosurg,2013.[Epub ahead of print].
13.	Cui X,Ma YZ,Chen X,et al.Outcomes of different surgical procedures in the treatment of spinal tuberculosis in adults.Med Princ Pract,2013,22(4):346-350.
14.	Lv GH,Wang B,Li J,et al.Thoracoscopy-assisted mini-open surgery for anterior column reconstruction in thoracic spinal tuberculosis.Orthop Surg,2009,1(4):293-299.
15.	姜立义,王峰,高宗伯.胸腔镜下前路病灶清除植骨内固定治疗胸椎结核28例临床分析.中国医药科学,2012,2(17):180,182.
16.	Cunningham BW,Kotani Y,McNulty PS,et al.Video-assisted thoracoscopic surgery versus open thoracotomy for anterior thoracic spinal fusion.A comparative radiographic,biomechanical,and histologic analysis in a sheep model.Spine (Phila Pa 1976),1998,23(12):1333-1340.
17.	Lü G,Wang B,Li J,et al.Anterior debridement and reconstruction via thoracoscopy-assisted mini-open approach for the treatment of thoracic spinal tuberculosis:minimum 5-year follow-up.Eur Spine J,2012,21(3):463-469.
18.	Ma YZ,Cui X,Li HW,et al.Outcomes of anterior and posterior instrumentation under different surgical procedures for treating thoracic and lumbar spinal tuberculosis in adults.Int Orthop,2012,36(2):299-305.
19.	王建华,尹庆水,夏虹,等.数字骨科技术在寰枢椎个体化置钉手术中的应用.脊柱外科杂志,2011,9(3):165-168.
20.	Jayaswal A,Upendra B,Ahmed A,et al.Video-assisted thoracoscopic anterior surgery for tuberculous spondylitis.Clin Orthop Relat Res,2007,460:100-107.
21.	Longo UG,Papapietro N,Maffulli N,et al.Thoracoscopy for minimally invasive thoracic spine surgery.Orthop Clin North Am,2009,40(4):459-464,vii.
22.	Xu L,Jian-Zhong X,Xue-Mei L,et al.Drug susceptibility testing guided treatment for drug-resistant spinal tuberculosis:a retrospective analysis of 19 patients.Int Surg,2013,98(2):175-180.
23.	Takeo S,Fukuyama S.Video-assisted thoracoscopic resection of a giant anterior mediastinal tumor (lipoma) using an original sternum-lifting technique.Jpn J Thorac Cardiovasc Surg,2005,53(10):565-568.
24.	Herrera-Soto JA,Parikh SN,Al-Sayyad MJ,et al.Experience with combined video-assisted thoracoscopic surgery (VATS) anterior spinal release and posterior spinal fusion in Scheuermann's kyphosis.Spine (Phila Pa 1976),2005,30(19):2176-2181.

1. 陈云生,游辉,陈荣春,等.胸腔镜辅助下前路病灶清除植骨内固定治疗胸椎结核.中国矫形外科杂志,2011,19(3):184-187.
2. 彭明,戚超,曹新峰,等.胸腔镜辅助下前路一期病灶清除及植骨内固定术治疗胸椎结核.中国修复重建外科杂志,2010,24(11):1405-1406.
3. 陈玉兵,陆声,徐永清,等.数字化导航模板辅助胸椎椎弓根螺钉置钉实验研究.中国骨科临床与基础研究杂志,2010,2(2):125-129.
4. 吕国华,王冰,李晶,等.胸腔镜辅助小切口胸椎结核前路重建手术的临床研究.中华医学杂志,2006,86(43):3043-3046.
5. Wang Z,Shi J,Geng G,et al.Ultra-short-course chemotherapy for spinal tuberculosis:five years of observation.Eur Spine J,2013,22(2):274-281.
6. Wang Z,Wu Q,Geng G.Anterior debridement and bone grafting with posterior single-segment internal fixation for the treatment of mono-segmental spinal tuberculosis.Injury,2013,44(2):253-257.
7. Wang B,Lv G,Liu W,et al.Anterior radical debridement and reconstruction using titanium mesh cage for the surgical treatment of thoracic and thoracolumbar spinal tuberculosis:minimium five-year follow-up.Turk Neurosurg,2011,21(4):575-581.
8. Zhang H,Sheng B,Tang M,et al.One-stage surgical treatment for upper thoracic spinal tuberculosis by internal fixation,debridement,and combined interbody and posterior fusion via posterior-only approach.Eur Spine J,2013,22(3):616-623.
9. Rigotti S,Boriani L,Luzi CA,et al.Minimally invasive posterior stabilization for treating spinal tuberculosis.J Orthop Traumatol,2013,14(2):143-145.
10. Zhang HQ,Li JS,Zhao SS,et al.Surgical management for thoracic spinal tuberculosis in the elderly:posterior only versus combined posterior and anterior approaches.Arch Orthop Trauma Surg,2012,132(12):1717-1723.
11. Tuli SM.Historical aspects of Pott's disease (spinal tuberculosis) management.Eur Spine J,2013,22 Suppl 4:529-538.
12. Kaloostian PE,Gokaslan ZL.Current management of spinal tuberculosis:a multimodal approach.World Neurosurg,2013.[Epub ahead of print].
13. Cui X,Ma YZ,Chen X,et al.Outcomes of different surgical procedures in the treatment of spinal tuberculosis in adults.Med Princ Pract,2013,22(4):346-350.
14. Lv GH,Wang B,Li J,et al.Thoracoscopy-assisted mini-open surgery for anterior column reconstruction in thoracic spinal tuberculosis.Orthop Surg,2009,1(4):293-299.
15. 姜立义,王峰,高宗伯.胸腔镜下前路病灶清除植骨内固定治疗胸椎结核28例临床分析.中国医药科学,2012,2(17):180,182.
16. Cunningham BW,Kotani Y,McNulty PS,et al.Video-assisted thoracoscopic surgery versus open thoracotomy for anterior thoracic spinal fusion.A comparative radiographic,biomechanical,and histologic analysis in a sheep model.Spine (Phila Pa 1976),1998,23(12):1333-1340.
17. Lü G,Wang B,Li J,et al.Anterior debridement and reconstruction via thoracoscopy-assisted mini-open approach for the treatment of thoracic spinal tuberculosis:minimum 5-year follow-up.Eur Spine J,2012,21(3):463-469.
18. Ma YZ,Cui X,Li HW,et al.Outcomes of anterior and posterior instrumentation under different surgical procedures for treating thoracic and lumbar spinal tuberculosis in adults.Int Orthop,2012,36(2):299-305.
19. 王建华,尹庆水,夏虹,等.数字骨科技术在寰枢椎个体化置钉手术中的应用.脊柱外科杂志,2011,9(3):165-168.
20. Jayaswal A,Upendra B,Ahmed A,et al.Video-assisted thoracoscopic anterior surgery for tuberculous spondylitis.Clin Orthop Relat Res,2007,460:100-107.
21. Longo UG,Papapietro N,Maffulli N,et al.Thoracoscopy for minimally invasive thoracic spine surgery.Orthop Clin North Am,2009,40(4):459-464,vii.
22. Xu L,Jian-Zhong X,Xue-Mei L,et al.Drug susceptibility testing guided treatment for drug-resistant spinal tuberculosis:a retrospective analysis of 19 patients.Int Surg,2013,98(2):175-180.
23. Takeo S,Fukuyama S.Video-assisted thoracoscopic resection of a giant anterior mediastinal tumor (lipoma) using an original sternum-lifting technique.Jpn J Thorac Cardiovasc Surg,2005,53(10):565-568.
24. Herrera-Soto JA,Parikh SN,Al-Sayyad MJ,et al.Experience with combined video-assisted thoracoscopic surgery (VATS) anterior spinal release and posterior spinal fusion in Scheuermann's kyphosis.Spine (Phila Pa 1976),2005,30(19):2176-2181.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS AND SAFETY ASSESSMENTS OF THORACOSCOPIC THORACIC TUBERCULOSIS CLEARANCE AND INTERNAL FIXATION WITH BONE GRAFTING SUPPORTED BY DIGITAL TECHNOLOGY

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content