Combined surgical treatment of tuberculosis spondylitis in the cervical and thoracic parts of spinal column
Patient K, age 21
Two years ago, he was diagnosed with spinal column tuberculosis at the level of C7 to T1 vertebrae. He did not receive any treatment. As time passed, pain began to intensify, and he began to experience numbness and weakness in the upper and lower extremities. Based on physical and instrumental examinations at another clinic, he was diagnosed with pathological fracture at the level of C7 – T1 – T2, local very severe kyphosis, spinal cord injury (myelopathy), and an operation was performed: fixation of the posterior spine in the same position (in situ).
However, after the surgery, because the patient’s kyphosis did not assume the correct anatomic position and exerted pressure on the spinal cord, the weakness in the patient’s arms and legs continued to progress. The patient, who came to us with these complaints, had his posterior vertebral implants removed first after the initial examination. The patient was then turned over onto his back, his sternum was incised (sternotomy), and the C7 – T1 – T2 vertebral bodies along with the intervertebral discs were removed. A titanium construction filled with bone was placed in the place of the resulting cavity.
After placing bone grafts around the construct, the titanium plate was fixed with four screws at the level of the C6 and T3 vertebrae. Next, after closing the wound surface, the patient was turned face down and revision inserted into C3, C4, C5, C6, T3, T4 and T5 vertebrae and after giving an anatomical shape to the kyphosis, fixation was performed.
After all layers of the wound were stitched according to the rules, the operation was completed. The operation lasted for 9 hours. Fifteen months had passed since the surgery, and the patient could move without any help.
