Endoscopy-assisted anterior cervical debridement combined with posterior fixation and fusion for the treatment of upper cervical spine tuberculosis: a retrospective feasibility study

• Published in: BMC musculoskeletal disorders Vol. 23; no. 1; p. 126
• Main Authors: Liu, Zheng, Xu, Zhenchao, Zhang, Yilu, Wang, Xiyang, Zhang, Zhen, Jiang, Dingyu, Jia, Runze
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 08.02.2022; BioMed Central; BMC
• Subjects: Abscesses; Anterior cervical debridement; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Debridement; Endoscopy; Erythrocyte sedimentation rate; Evaluation; Feasibility Studies; Female; Humans; Intubation; Magnetic resonance imaging; Male; Methods; Musculoskeletal diseases; Neck pain; Pain; Paralysis; Patients; Posterior fixation; Posterior fusion; Retrospective Studies; Skin & tissue grafts; Spinal cord; Spinal Fusion - adverse effects; Spine; Spine (cervical); Surgery; Thoracic Vertebrae; Titanium; Treatment Outcome; Tuberculosis; Tuberculosis, Spinal - diagnostic imaging; Tuberculosis, Spinal - surgery; Upper cervical spine; China; Posterior fusion; Anterior cervical debridement; Posterior fixation; Tuberculosis; Endoscopy; Upper cervical spine
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-022-05084-4

This retrospective study aimed to determine the feasibility and efficacy of endoscopy-assisted anterior cervical debridement combined with posterior fixation and fusion in patients with upper cervical spine tuberculosis. Between June 2008 and January 2016, 17 patients (10 men and 7 women) with upper cervical spine tuberculosis underwent endoscopy-assisted anterior cervical debridement combined with posterior fixation and fusion. Anti-tuberculosis treatment was administered for 2-4 weeks preoperatively and 12-18 months postoperatively. The clinical and radiographic data of the patients were analyzed. The operation was successfully completed in all patients. Neck pain and stiffness were relieved after the surgery in all patients. The mean operation time was 210.0 ± 21.2 min, and the mean intraoperative blood loss was 364.7 ± 49.6 mL. The mean follow-up duration was 68.1 ± 6.7 months. The erythrocyte sedimentation rate returned to normal by 3 months postoperatively. Visual analog scale scores for neck pain were significantly lower postoperatively than preoperatively. All patients had significant postoperative neurological improvement. Patient-reported outcomes, as measured using the Kirkaldy-Willis criteria, were as follows: excellent, 12 patients; good, 4 patients; fair, 1 patient; and poor, 0 patients. Bone fusion was achieved at 10.9 ± 1.9 months after the surgery; no cases of instrument loosening or fracture occurred. Endoscopy-assisted anterior cervical debridement combined with posterior fixation and fusion is a feasible and effective surgical method for the treatment of upper cervical spine tuberculosis. It can be used to restore upper cervical spine stability and facilitate spinal healing.