Clinical Observation Of Thoracoscopic Assisted Small Incision In Treatment Of Thoracic Tuberculosis

Objective: Explain the postoperative recovery of thoracic spinal tuberculosis with thoracoscopic surgery assisted small incision.Methods: Collecting cases of spine surgery in our hospital from December 2015 to April 2017 underwent thoracoscopic assisted small incision thoracic tuberculosis with bone graft fusion and internal fixation.A total of 8 cases,including 3 males and 5 females,mean age 48.5 years old,lesions involving 2 thoracic in 7 cases,involving only 1 thoracic in 1 case.The VAS scores were collected and analyzed by observing the time of the operation,the amount of intraoperative blood loss,the placement time of the thoracic closed drainage tube,the length of hospital stay,postoperative complications,preoperative and postoperative 1 week,1 month,3 months and 6 months,Preoperative and postoperative 1 month,3 months,6 months ESR,six months after the assessment of improved Macnab efficacy,Frankel grade improvement after 6 months and 1 year after surgery,bone fusion rate and so on.To explain the postoperative recovery of the operation.Results: All operations were successfully completed,8 patients were more than 1 year follow-up.The operative time(244 ± 94 min),intraoperative bleeding(136 ± 89 ml),hospital stay(23 ± 5 days),drainage time(7 ± 2 days).No intraoperative nerve injury and postoperative pneumothorax,postoperative lung failure,infection and other complications.The VAS scores were(5.6 ± 1.3),(4.4 ± 1.1),(2.8 ± 0.7),(1.4 ± 0.7)and(0.5 ± 0.5),The VAS scores at 1 week,1 month,3 months and 6 months after operation were significantly lower than those before operation,P <0.05,the difference was statistically significant.The VAS scores at 1 week,1 month,3 months and 6 months after operation Compared with preoperative decreased gradually,indicating that patients with chest and back pain symptoms gradually eased.The ESR at preoperative,1 month,3 months and 6 months postoperatively were(64.4 ± 26.47),(41.75 ± 18.70),(31.75 ± 19.04)and(27.88 ± 12.52),compared with preoperative ESR at 1 month,3 months,and 6 months after surgery,P<0.05,the difference was statistically significant.,1 month after surgery,3 months,6 months ESR decreased gradually compared with preoperative,indicating that patients with tuberculosis poisoning symptoms Gradually ease.Postoperative six months follow-up evaluation of improved Macnab efficacy,excellent and good rate of 87.5%.Three patients with preoperative nerve injury,1 year after surgery,two FrankelD recovered to FrankelE,and one FrankelC returned to FrankelD.Imaging examination at 6 months after operation suggested bone graft union and bone graft fusion rate of 100%.Conclusion: Thoracoscopic assisted small incision for the treatment of thoracic spinal tuberculosis provides a safe,effective and practical minimally invasive surgical method for the treatment of thoracic spinal tuberculosis.