caa a22 4500 606214054 CHVBK 20210128101050.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s00701-015-2507-4 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2507-4 Retrospective feasibility analysis of modified posterior partial vertebrectomy with 360-degree decompression in destructive thoracic spondylodiscitis [Elektronische Daten] [Marc Dreimann, Lennart Viezens, Michael Hoffmann, Sven Eicker] Background: Advanced states of vertebral osteomyelitis accompanied by spinal instability, epidural abscess formation, and neurological deficits require surgical decompression, stabilization, and often reconstruction of the anterior and posterior columns. The efficacy of a posterolateral approach with resection of inflammatory tissue, and interbody (titanium cages) and dorsal fusion was investigated and the clinical and radiological parameters (correction of kyphosis and fusion rates) were evaluated. Method: From 2011 to 2014, ten consecutive patients were treated at our institution using the modified technique of a transversecomy without costal resection to decompress neural structures and resect inflammatory tissue in destructive thoracic vertebral osteomyelitis. Flattening of the endplates without complete corpectomy, 360-degree stabilization, and correction of kyphosis by posterior shortening instead of anterior distraction were performed to avoid an additional ventral approach. Clinical and radiological data were retrospectively analyzed. Results: All ten patients (six male and four female, mean age, 66years) suffered from severe and destructive osteomyelitis. Surgery was performed successfully in all ten patients. Mean surgical time was 308min. Mean follow-up was 19months (range, 2-32months). Neither approach-related or pulmonary complications nor recurrence of osteomyelitis were observed. All patients experienced pain relief after the procedure (mean back pain VAS was 8.8 pre-treatment and 3.2 at the final follow-up). Fusion was observed in all patients on the basis of computerized tomography scans. The mean radiological segmental kyphosis was corrected from 20° preoperatively to 7° after surgery and 9° at the final follow-up. Conclusions: The modified posterior transversectomy with 360-degree decompression and anterior wall reconstruction with titanium cages in combination with posterior instrumentation for sagittal alignment correction is a reliable, effective, and safe treatment option. Springer-Verlag Wien, 2015 Thoracic osteomyelitis nationallicence Vertebral osteomyelitis nationallicence Spinal infection nationallicence Transversectomy nationallicence Dreimann Marc Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut Viezens Lennart Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut Hoffmann Michael Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut Eicker Sven Department of Neurosurgery, University Hospital Hamburg Eppendorf, Hamburg, Germany aut Acta Neurochirurgica Springer Vienna 157/9(2015-09-01), 1611-1618 0001-6268 157:9<1611 2015 157 701 https://doi.org/10.1007/s00701-015-2507-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2507-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Dreimann Marc Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Viezens Lennart Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Hoffmann Michael Department of Trauma, Hand and Reconstructive Surgery, University Hospital Hamburg Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Eicker Sven Department of Neurosurgery, University Hospital Hamburg Eppendorf, Hamburg, Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/9(2015-09-01), 1611-1618 0001-6268 157:9<1611 2015 157 701