Objective The main objective of this study was to analyze the efficacy and feasibility of surgical management for patients with thoracic spinal tuberculous spondylitis (STB) by using posterior-only transforaminal debridement and interbody fusion (PTDIF) with preservation of posterior ligamentous complex (PLC) and noninferior of PTDIF compared with conventional posterior-only debridement and interbody fusion (CPDIF).
Methods From January 2019 to January 2022, a prospective, randomized, controlled trial was conducted in which patients with thoracic STB were enrolled and assigned to undergo either the PTDIF group (group A) or CPDIF group (group B) in a 1:1 ratio. The clinical efficacy was evaluated on average operation time, blood loss, hospitalization durations, visual analogue scale, Oswestry Disability Index scores, erythrocyte sedimentation rate (ESR), C-Reactive protein (CRP), and neurological function recovery using the American Spinal Injury Association’s impairment scale and operative complications. Radiological measurements included kyphosis correction, loss of correction. The outcomes were compared between the groups at preoperation, postoperaion, and final follow-up.
Results All 65 patients were completely cured during the follow-up. The intraoperative blood loss and operation time in group B were more than that in group A. All patients were pain-free at the final follow-up visit. ESR, CRP returned to normal limits in all patients 3 months after surgery. All patients had improved neurological signs. No significant difference was found in kyphosis angle correction, loss of correction between the 2 groups.
Conclusion PTDIF, with preservation of PLC, achieved debridement, decompression, and reconstruction of the spine’s stability, similar to CPDIF in the surgical treatment of thoracic STB. PTDIF has less surgical trauma with less intraoperative blood loss and operation time.
Citations
Citations to this article as recorded by
Comparative Clinical Efficacy and Safety of Multi‐Segment Thoracolumbar Tuberculosis Treated Through the Posterior “Detour Method” Versus the Combined Anterior–Posterior Approach: A Technique Note and Preliminary Retrospective Study Dian Zhong, Wei Zeng, Guosheng Zhao, Yu Du, Yang Wang, Zhenyong Ke Orthopaedic Surgery.2026; 18(7): 1508. CrossRef
From single ligament to multi-ligament injury: a finite element study on the contribution of the posterior ligamentous complex to segmental stability and intervertebral disc stress distribution Jingbo Ma, Yu Ding, Rigbat Rozi, Jiaheng Han, Qiang Jiang BMC Musculoskeletal Disorders.2025;[Epub] CrossRef
Objective Syringomyelia is a common central nervous system disease characterized by the dilation of the central canal (CC). Regarding the pathogenesis of syringomyelia, cerebrospinal fluid (CSF) circulation obstruction in the subarachnoid space (SAS) of the spinal cord has been widely accepted. However, clinical and animal studies on obstructing the CSF in SAS failed to form syringomyelia, challenging the theory of SAS obstruction. The precise pathogenesis remains unknown.
Methods We utilized an extradural compression rat model to investigate the pathogenesis underlying syringomyelia. Magnetic resonance imaging enabled detection of syringomyelia formation. To assess CSF flow within the SAS, Evans blue was infused into the cisterna magna. Histological analysis allowed morphological examination of the CC. Furthermore, CSF flow through the CC was traced using Ovalbumin Alexa-Flour 647 conjugate (OAF-647). Scanning electron microscopy (SEM) enabled visualization of ependymal cilia.
Results The findings showed that the dura mater below the compression segment exhibited lighter coloration relative to the region above the compression, indicative of partial obstruction within the SAS. However, the degree of SAS occlusion did not significantly differ between syringomyelia (SM-Y group) and those without (SM-N group). Intriguingly, hematoxylin and eosin staining and CSF tracing revealed occlusion of the CC accompanied by reduced CSF flow in the SM-Y group compared to SM-N and control groups. SEM images uncovered impairment of ependymal cilia inside the syringomyelia.
Conclusion CC occlusion may represent a physiological prerequisite for syringomyelia formation, while SAS obstruction serves to initiate disease onset. The impairment of ependymal cilia appears to facilitate progression of syringomyelia.
Citations
Citations to this article as recorded by
A novel Minimally-Invasive technique for Non-Traumatic postoperative adhesive Syringomyelia Can Zhang, Chenghua Yuan, Jiachen Wang, Hao Wu, Zan Chen, Fengzeng Jian, Jian Guan European Spine Journal.2026; 35(4): 2095. CrossRef
Thecoperitoneal shunt placement for extensive spinal adhesive arachnoiditis or lumbosacral outlet obstruction with syringomyelia Fan Yuan, Chenghua Yuan, Chao Chang, Tailai Li, Hao Wu, Zan Chen, Marcus A. Stoodley, Fengzeng Jian, Jian Guan European Spine Journal.2026;[Epub] CrossRef
Glial scarring limits recovery following decompressive surgery in rats with syringomyelia Shengyu Cui, Jinze Li, Can Zhang, Qian Li, Chuan Jiang, Xinyu Wang, Xiaoxu Yu, Kang Li, Yuxin Feng, Fengzeng Jian Experimental Neurology.2025; 385: 115113. CrossRef
Effectiveness of Cerebellar Tonsillectomy Treatment for Revision Chiari Malformation Surgery: A Series of 63 Patients Fan Yuan, Chenghua Yuan, Dingran Li, Pingchuan Xia, Jian Guan, Yueqi Du, Can Zhang, Zhenlei Liu, Kai Wang, Wanru Duan, Zuowei Wang, Xingwen Wang, Hao Wu, Zan Chen, Fengzeng Jian World Neurosurgery.2025; 196: 123690. CrossRef
A Novel Surgical Technique for Post-traumatic Syringomyelia Progressing to the Medulla Oblongata: Evidence of Upward Drainage of Central Canal Fluid Within the Spinal Cord Chenghua Yuan, Zhencheng Xiong, Houyuan Lv, Chenyuan Ding, Pingchuan Xia, Huixin Xue, Hui Zhan, Mingchu Li, Yueqi Du, Can Zhang, Zhenlei Liu, Kai Wang, Wanru Duan, Zuowei Wang, Xingwen Wang, Hao Wu, Zan Chen, Fengzeng Jian, Jian Guan Neurosurgery.2025; 97(2): 424. CrossRef
First
Prev
