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[Clinical research of thoracoscopy-assisted mini-open surgery for anterior column reconstruction of thoracic spine tuberculosis].

OBJECTIVE
To evaluate the clinic effects of thoracoscopy-assisted mini-open surgery for anterior column reconstruction of thoracic spine tuberculosis.


METHODS
Sixty patients with thoracic spine tuberculosis, involving segments T4 to T12, with a kyphotic angle of 29.2 degrees (18-42 degrees), 38 males and 22 females, aged 47.4 (19-68), with large paraspinal abscess in 50 cases, pleurisy in 17, and dural compression in 42 cases shown by imaging examination, underwent thoracoscopic-assisted mini-open surgery, including radical debridement and anterior spinal reconstruction. According to Frankel's grade, the preoperative neurological function was judged as: Grade A in 1 case, Grade B in 4, Grade C in 6, Grade D in 19, and Grade E in 30. The patients were followed up for 3.6 years. The outcomes were evaluated retrospectively.


RESULTS
The operation was accomplished successfully in all 60 patients. The average operative time was 230 min (180-320 min), the average blood loss during operation was 570 ml (350-1200 ml), the mean drainage duration was 3.6 d (3-5 d). Complications occurred in 18 patients (30%). 30 patients showed neurological improvement from 1 to 3 Grades at the last follow-up. The average correction rate of kyphotic angle was 36.6%, and no obvious correction loss was detected during the follow-up. No patient showed recurrence of tuberculosis.


CONCLUSION
Thoracoscopy-assisted mini-open surgery provides a simple, safe, effective, and practical technology with minimal invasiveness for the treatment of thoracic spine tuberculosis.