Clinical Outcome of Transpleural Extreme Lateral Interbody Fusion Combined with Posterior Open Internal Fixation for the Treatment of One-Segment Thoracic Spondylodiscitis.

Abstract

To evaluate the clinical outcome of transpleural extreme lateral interbody fusion (TP-XLIF) combined with posterior open internal fixation in treating thoracic spondylodiscitis. We present a single-center case series on the use of TP-XLIF combined with posterior open internal fixation in treating thoracic spondylodiscitis between January 2018 and December 2022. Perioperative characteristics, clinical outcomes, and complications were retrospectively collected. A total of 9 patients were included in this study. The lateral approach time (time for TP-XLIF) and the total operative time were 75 ± 16 minutes and 210 ± 28 minutes, respectively, and the estimated blood loss for the lateral approach and the total estimated blood loss were 148 ± 36 mL and 303 ± 59 mL, respectively. According to the preoperative baseline, the visual analog scale scores for back pain and Oswestry Disability Index scores of all patients demonstrated significant reductions at 1 month, 3 months, and the final follow-up postoperatively. All 9 patients obtained bony fusion in 1 year. There were varying degrees of height loss and local kyphosis at the involved segments before surgery, and they demonstrated significant improvement postoperatively. Two patients developed pleural effusion postoperatively, and they were successfully managed by placement of thoracic drainage tubes. Data in this study demonstrated that TP-XLIF combined with posterior open internal fixation was an optional strategy in treating thoracic spondylodiscitis and was associated with less surgical trauma and blood loss, fast postoperative recovery, satisfactory intervertebral height and kyphosis correction, and rapid bone graft fusion.