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Journal of Korean Neurosurgical Society 1992;21(7): 879-883.
Posterolateral Thoracotomy Approach to Tuberculous Spondylitis of the Upper Thoracic Vertebrae.
Seung Myung Lee, Gye Hune Ahn, Choong Hyeon Kim
Department of Neurosurgery, College of Medicine, Chosun University, Kwangju, Korea.
Bone and joint involement develops in approximately 10 percent of patients with tuberculosis and half of these affected patients have tuterculosis of the spine. The goals of management are to eradicate the infection and to prevent or treat neurologic deficits and spinal deformity. An operation may be performed to drain abscess, to debride sequestered bone and disc, to decompress the spinal cord, or to stabilize the spine for the prevention of correction of deformity. But there are difficulties in approaching the upper thoracic spine(T1-T3). These vertebral bodies can be visualize through a standard thoracotomy. Access is greatly restricted, however, by the scapula and the remaining rabs, making a vertebrectomy and spinal cord decompression very difficult. Reconstruction of the vertebral defect and instrumentation to give spinal stability are equally difficult. We describe a surgical approach to the upper thoracic spine which allow an adequate exposure of the vertebral bodies from T1 to T3. The posterolateral thoracotomy approach seems to be a safe and useful method for the upper thoracic lesion, allows adequate exposure exposure and easy reconstruction.
Key Words: Tuberculous spondylitis; Upper thoracic vertebrae; Posterolateral thoracotomy approach
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