Video-assisted thoracoscopic surgery in managing tuberculous spondylitis

Tsung Jen Huang, Robert Wen Wei Hsu, Shih Hao Chen, Hui Ping Liu

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

The literature includes no studies on the use of video-assisted thoracoscopic surgery in the management of tuberculous spondylitis, and its role in the management of tuberculosis involving the thoracic spine remains unclear. The authors experience with 10 consecutive patients (six women, four men) who underwent video-assisted thoracoscopic surgery for the treatment of spinal tuberculosis involving levels from T5 to T11, from January 1996 to December 1997, was analyzed. Using the extended manipulating channel method (2.5-3.5 cm portal incisions), video-assisted thoracoscopic surgery was performed with a three-portal technique (seven patients) or a modified two-portal minithoracotomy technique that required a small incision for the thoracoscope and a larger incision, measuring 5 to 6 cm, for the procedures in three patients. All the patients were studied prospectively. The followup ranged from 17 to 42 months (mean, 24 months). Post-operative complications included one lung atelectasis. Pleural adhesions, owing to local inflammation or paravertebral abscess, were seen in four patients and one patient with severe pleurodesis needed an open technique for treatment. Postoperative air leaks were seen in four (40%) of 10 patients but all were transient. The average neurologic recovery was 1.1 grades on the Frankel's scale. The data from this series of patients with tuberculous spondylitis show that video-assisted thoracoscopic surgery has diagnostic and therapeutic roles in the management of tuberculous spondylitis. Technically, a combination of thoracoscopy and conventional spinal instruments to perform video-assisted thoracoscopic surgery through the extended manipulating channels, which were placed slightly more posterior than usual, was effective and safe.

Original languageEnglish
Pages (from-to)143-153
Number of pages11
JournalClinical Orthopaedics and Related Research
Issue number379
Publication statusPublished - 2000
Externally publishedYes

Fingerprint

Spondylitis
Video-Assisted Thoracic Surgery
Thoracoscopes
Spinal Tuberculosis
Pleurodesis
Thoracoscopy
Pulmonary Atelectasis
Abscess
Nervous System
Tuberculosis
Spine
Thorax
Therapeutics
Air
Inflammation
Lung

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Video-assisted thoracoscopic surgery in managing tuberculous spondylitis. / Huang, Tsung Jen; Hsu, Robert Wen Wei; Chen, Shih Hao; Liu, Hui Ping.

In: Clinical Orthopaedics and Related Research, No. 379, 2000, p. 143-153.

Research output: Contribution to journalArticle

Huang, Tsung Jen ; Hsu, Robert Wen Wei ; Chen, Shih Hao ; Liu, Hui Ping. / Video-assisted thoracoscopic surgery in managing tuberculous spondylitis. In: Clinical Orthopaedics and Related Research. 2000 ; No. 379. pp. 143-153.
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