%0 Journal Article
%T Video-Assisted Thoracic Surgery for Tubercular Spondylitis
%A Roop Singh
%A Paritosh Gogna
%A Sanjeev Parshad
%A Rajender Kumar Karwasra
%A Parmod Kumar Karwasra
%A Kiranpreet Kaur
%J Minimally Invasive Surgery
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/963497
%X The present study evaluated the outcome of video-assisted thoracic surgery (VATS) in 9 patients (males = 6, females = 3) with clinico-radiological diagnosis of tubercular spondylitis of the dorsal spine. The mean duration of surgery was 140.88 ¡À 20.09 minutes, mean blood was 417.77 ¡À 190.90£¿mL, and mean duration of postoperative hospital stay was 5.77 ¡À 0.97 days, Seven patients had a preoperative Grade A neurological involvement, while at the time of final followup the only deficit was Grade D power in 2 patients. In patients without bone graft placement (n = 6), average increase in Kyphosis angle was 16¡ã, while in patients with bone graft placement (n = 3) the deformity remained stationary. At the time of final follow up, fusion was achieved in all patients, the VAS score for back pain improved from a pretreatment score of 8.3 to 2, and the function assessment yielded excellent (n = 4) to good (n = 5) results. In two patients minithoracotomy had to be resorted due to extensive pleural adhesions (n = 1) or difficulty in placement of graft (n = 1). Videoassisted thoracoscopic surgery provides a safe and effective approach in the management of spinal tuberculosis. It has the advantages of decreased blood loss and post operative morbidity with minimal complications. 1. Introduction Tuberculous spondylitis, which is the most common form of skeletal TB (comprising 50% of all cases) and the most serious form of tuberculous lesions in various bones and joints, is reappearing as a problem [1¨C5]. In the developing world spinal TB is the main cause of kyphosis; 15% of patients treated conservatively have a considerable increase in kyphotic deformity, which in 3% to 5% is more than 60¡ã. A severe kyphotic deformity is a major cosmetic and psychological disturbance in growing child and can result in secondary cardiorespiratory problems and late-onset paraplegia [6¨C9]. The standard surgical method of decompression of tubercular dorsal spine is either the anterolateral extrapleural or the open transthoracic transpleural approach. Both these approaches are sufficient for adequate decompression and graft placement but are associated with significant morbidity and require a prolonged hospital stay [10]. Video-assisted thoracic surgery (VATS) has developed very rapidly in the last two decades. The use of VATS retains the advantages of anterior spinal surgery and gives a comparable result of spinal deformity correction to that of the open approaches [11]. Although the advent of video-assisted thoracoscopic surgery (VATS) has given a valuable alternative to conventional
%U http://www.hindawi.com/journals/mis/2014/963497/