One-stage posterior surgical treatment of the rare thoracolumbar spine process and laminar nucleus with incomplete paralysis: a retrospective study.

Abstract

Background: The study was to evaluate the results of the one-stage posterior approach in treating patients with the rare thoracic and lumbar spinous process and vertebral laminae tuberculosis of the spine with incomplete paralysis.

Materials and methods: 21 patients who were treated with bone graft fusion, debridement, spinal canal decompression, and posterior transpedicle internal fixation vie one-stage posterior approach were collected and analyzed. The data was collected at perioperative period and at the final follow-up visit.

Results: The follow up time was at an average of 21.62 ± 2.17 months. The mean age of these patients was 44.81 ± 17.76 years. The intraoperative blood loss and operative time were 538.09 ± 180.21 mL and170.95 ± 20.08 min, respectively. The C-reactive protein (CRP) level and erythrocyte sedimentation rate (ESR) decreased to normal by the last follow-up evaluation. The Oswestry Disability Index (ODI)and visual analogue scale (VAS) were substantially improved 4 weeks postoperatively and at the last follow-up evaluation (P < 0.05). The incomplete paralysis had improved significantly at the last follow-up evaluation based on the American Spinal Injury Association (ASIA) grade (P < 0.05). All patients achieved the bony fusion criteria. The average fusion time was 11.200 ± 2.16 months.

Conclusions: The one-stage posterior approach is an efficient and safe surgical option for treating thoracic and lumbar spinous processes and vertebral laminae tuberculosis of the spine with incomplete paralysis. Surgical decompression is very necessary for the recovery of neurological function.