Video-Assisted Thoracoscopic Surgery Combined with Posterior Percutaneous Internal Fixation: A Novel Minimally Invasive Approach for Treating Thoracic Spinal Infections

Video-Assisted Thoracoscopic Surgery Combined with Posterior Percutaneous Internal Fixation: A Novel Minimally Invasive Approach for Treating Thoracic Spinal Infections | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Video-Assisted Thoracoscopic Surgery Combined with Posterior Percutaneous Internal Fixation: A Novel Minimally Invasive Approach for Treating Thoracic Spinal Infections Huigang An, Wenkai Ruan, Liang Xu, Yongrui Yang, Jianlong Li, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8086720/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Thoracic spinal infections, such as infectious spondylodiscitis, pose significant challenges, with goals of eradicating infection, preserving neurologic function, and maintaining spinal alignment.The surgical approach for treating thoracic spine infections remains controversial，Video-assisted thoracoscopic surgery (VATS) combined with posterior percutaneous internal fixation offers a minimally invasive alternative for debridement, drainage, and stabilization. Objectives: To assess the efficacy and safety of VATS combined with posterior percutaneous internal fixation in treating thoracic spinal infections, evaluating patient demographics, inflammatory markers, pain levels, kyphotic angles, and clinical outcomes. Study Design :Retrospective observational study . Setting: Department of Orthopedics, Shandong Provincial Public Health Clinical Center. Methods: From January 2022 to January 2025, 39 patients with thoracic spinal infections underwent video-assisted thoracoscopic surgery (VATS) for debridement, drainage, and microbiological culture to confirm causative pathogens, followed by posterior percutaneous internal fixation for stabilization. Patients were selected based on failure of conservative therapy, confirmed by CT and MRI. Both preoperatively and postoperatively, inflammatory markers (CRP 、ESR), Visual Analogue Scale (VAS) scores, complications, and kyphosis angles were monitored. Results: Thirty-nine patients were included, with their demographic characteristics, clinical profiles, and microbiological findings detailed in Table 1. Mean age was 58.28 ± 12.22 years (SD; range: 27–78 years). Gender distribution was relatively balanced (18 females [46.15%]; 21 males [53.85%]). Mean height and weight were 163.77 ± 12.22 cm (range: 106–178 cm) and 66.92 ± 14.81 kg (range: 45–93 kg), respectively.Causative pathogens were identified in 34 cases (culture rate: 87.18%) without prior antibiotic exposure.Pain was significantly alleviated in all cases.The mean preoperative Visual Analogue Scale (VAS) score of the 39 patients was 7.38 ± 1.25, which decreased to 3.15 ± 1.17 one week postoperatively and further reduced to 0.41 ±0.68 one month postoperatively.C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels normalized in 84.61% and 92.3% of Ascending triangle of patients by 3 months post-surgery, respectively. The mean kyphotic angle change was -0.21° ± 1.85°at the final follow-up, indicating no significant progression of sagittal deformity. No surgery-related complications were observed, and no conversions to open spinal surgery were required during the follow-up period. Limitations: Retrospective, single-center design introduces potential bias. Conclusions: VATS combined with posterior percutaneous internal fixation is a safe, effective strategy for thoracic spinal infections, offering high pathogen identification rates, minimal kyphotic changes, and low recurrence, positioning it as a viable alternative to traditional open approaches. Thoracic spine video-assisted thoracoscopic surgery percutaneous fixation spondylodiscitis minimally invasive surgery Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction Thoracic spinal infections, encompassing infectious spondylodiscitis and associated abscesses, represent a growing clinical challenge due to increasing rates of immunocompromised states, invasive procedures, and aging populations[ 1 ]. These infections often arise hematogenously or post-intervention, leading to debilitating pain, neurologic deficits, and structural instability. The triad of treatment objectives—eradicating infection, safeguarding neurologic function, and preserving spinal alignment—remains paramount. Conservative management, primarily involving prolonged antibiotic therapy, succeeds in approximately 75% of cases without neurologic compromise or deformity[ 2 – 4 ]. However, failure rates approach 25%, marked by persistent symptoms, worsening inflammatory markers, or radiographic progression. In such scenarios, surgery becomes the preferred intervention to achieve direct debridement, pathogen identification, and stabilization. Traditional open surgical approaches, such as anterior thoracotomy with corpectomy and fusion, or combined anterior-posterior procedures, have been the gold standard. Yet, these are fraught with drawbacks: extensive tissue dissection leads to significant blood loss (often exceeding 1,000 mL), elevated complication rates (including pulmonary issues, vascular injury, and wound infections up to 20%), and extended recovery periods (averaging 4–6 weeks of hospitalization)[ 5 – 6 ]. Elderly patients or those with comorbidities face heightened morbidity and mortality, with rates reported as high as 15–20%[ 7 – 10 ]. Minimally invasive techniques have emerged to mitigate these risks. This study evaluates the clinical outcomes of VATS combined with posterior percutaneous internal fixation in thoracic spinal infections, hypothesizing it as a feasible, effective alternative post-conservative failure. Methods Study Design A retrospective review of patients treated for thoracic spinal infections using VATS combined with posterior percutaneous internal fixation was conducted, assessing demographics, pathogen profiles, inflammatory responses, pain relief, kyphotic changes, and complications. Patient Population Inclusion Criteria: (1) Thoracic infectious spondylodiscitis confirmed by computed tomography (CT) and magnetic resonance imaging (MRI); (2) Thoracic infectious spondylodiscitis with or without paravertebral abscess; (3) Early-stage infection with poor response to conservative treatment; (4) Elevated C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR). Exclusion Criteria: (1) Patients with incomplete clinical data or missing follow-up records; (2) Patients with surgical contraindications or refusal to undergo surgical treatment; (3) Asymptomatic patients. Table 1. Patient characteristics (demographic and culture results). Number Age(yers)/Gender Height(cm)/Weight(kg) Leve Previous antibioitc/bacteria culture Associated medical illness 1 47/M 178/92 T7-8 Cocci/Linezolid Bronchiectasis 2 70/F 158/81 T7-8 P. aeruginosa/Meropenem HTN 3 35/M 175/60 T12-L1 TB/HRZE NONE 4 72/F 162/56 T8-9 TB/HRZE HYS 5 60/F 158/51 T12-L1 Escherichia coli/Imipenem HTN、DM 6 68/F 160/50 T11-12 Escherichia coli/Meropenem HTN 7 30/F 163/84 T10-11 TB/HRZE NONE 8 67/F 157/60 T8-9 TB/HRZE NONE 9 75/F 161/57 T11-12 TB/HRZE DM、CHD 10 48/F 160/68 T7-8 MSSA/Vancomycin、Linezolid NONE 11 64/F 155/60 T12-L1 MSSA/Vancomycin HTN、DM 12 62/F 160/75 T5-6 MRSA/Vancomycin NONE 13 57/M 175/75 T11-12 MSSA/Teicoplanin HTN、DM 14 69/F 160/49 T11-12 TB/HRZE DM 15 57/F 160/68 T8-9 Cocci/Moxifloxacin NONE 16 73/F 150/45 T12-L1 TB/HRZE PE 17 58/M 173/93 T10-11、T7-8 NTM/Lanamycin、Moxifloxacin、R SLE 18 72/M 163/75 T10-11 Escherichia coli/Meropenem HTN、DM 19 27/M 170/50 T10-11 TB/HRZE NONE 20 76/F 154/55 T9-10 MSSA/Vancomycin HTN、DM 21 48/M 176/84 T10-11 Escherichia coli/Imipenem NONE 22 59/M 170/68 T7-8 Klebsiella pneumoniae/Imipenem DM 23 57/F 158/61 T10-11 TB/HRZE HTN 24 60/M 168/90 T8-9 Cocci/Vancomycin DM 25 68/M 170/69 T4-5 MSSA/Vancomycin NONE 26 67/M 170/75 T7-8 TB/HRZE CHD、HUA 27 48/M 171/80 T11-12 Br/Doxycycline、R、Ceftriaxone HTN 28 50/M 160/54 T7-8 Bacilli/Imipenem NONE 29 76/F 158/62 T9-10 Br/Doxycycline、R、Ceftriaxone DM 30 39/M 170/90 T8-10 TB/HRZE NONE 31 55/M 163/55 T8-9 Escherichia coli/Imipenem NONE 32 49/F 106/68 T7-9 TB/HRZE NONE 33 60/M 165/70 T9-10 Aspergillus fumigatus/Micafungin AF、PE 34 35/F 158/46 T7-10 TB/HRZE PTB 35 78/F 162/59 T10-11 TB/HRZE HTN、DM、CHD 36 58/M 175/70 T11-12 Cocci/Vancomycin HTN 37 68/M 170/65 T5-6 TB/HRZE NONE 38 52/F 158/63 T7-8 TB/HRZE CHD 39 54/M 170/64 T6-7 Aggregatibacter/Meropenem GA Abbreviations：HTN，Hypertension；HYS，Hysterectomy；DM，Diabetes Mellitus；CHD，Chronic Heart Disease；PE，Pulmonary Embolism；SLE，Systemic Lupus Erythematosus；AF，Atrial Fibrillation；PTB，Pulmonary Tuberculosis；TB，Tuberculosis；HRZE，Isoniazid Rifampicin Pyrazinamide Ethambutol；MSSA，Methicillin-Sensitive Staphylococcus aureus；MRSA，Methicillin-Resistant Staphylococcus aureus；Br，Brucella；L, lumbar; T, thoracic；F， Female；M，Male. Table 2. Inflammatory markers before and after surgery. Number CRP(mg/dL) ESR(mm/1hr) Pre 1M 3M Pre 1M 3M 1 15.32 6.23 0.15 30 5 2 2 8.62 4.13 1.11 55 21 7 3 53.89 39.61 6.71 75 33 12 4 95.02 5.24 1.23 37 11 6 5 43.08 2.56 1.43 79 19 6 6 20.59 13.64 3.62 103 39 24 7 28.01 2.51 1.39 52 10 9 8 47.27 7.75 5.06 93 42 38 9 44.27 5.67 3.68 89 28 14 10 98.47 3.3 2.8 64 13 7 11 67.42 0.74 0.5 89 26 12 12 55.2 6.96 6.25 96 20 7 13 40.69 3.09 1.89 72 24 11 14 53.8 16.64 2.67 68 31 16 15 24.08 1.37 0.43 29 9 5 16 115.9 6.87 2.67 45 10 3 17 18.04 6.52 5.86 42 13 8 18 54.94 3.03 0.74 67 20 11 19 64.95 15.87 5.49 56 12 8 20 56.01 2.20 1.21 100 16 7 21 106.15 11.21 3.83 52 7 1 22 71.61 0.36 0.94 60 6 5 23 36.98 3.45 1.41 44 20 9 24 30.72 2.3 1.13 20 8 6 25 31.4 1.68 0.73 51 5 1 26 69.4 5.87 3.66 40 10 2 27 62.16 5.63 1.39 55 8 6 28 39.54 2.21 0.97 71 10 6 29 52.76 2.23 1.53 14 10 7 30 80.83 8.44 2.15 17 7 5 31 44.01 2.25 0.76 51 5 3 32 76.42 7.19 3.74 65 22 14 33 115.08 7.08 1.19 69 7 5 34 19.45 4.22 2.95 39 16 11 35 78.61 10.32 6.54 86 20 9 36 45.92 4.62 1.58 58 13 2 37 58.7 6.25 1.19 75 19 8 38 91.76 3.69 0.71 64 20 14 39 20.47 1.02 0.2 33 8 6 Gray squares represent abnormal data;Abbreviations：Pre，Preoperative；1M，1Month；3M，3Month. Table 3. Statistical normalization rate of inflammatory marker after operation Level CRP(Patient number/%) ESR(Patient number/%) Postop 1m Postop 3m Postop 1m Postop 3m Normal 17（43.58%） 33（84.61%） 21（53.84%） 36（92.3%） Abnorma 22（56.42%） 6（15.39%） 18（46.16%） 3（7.7%） Abbreviations: Postop, postoperative. Surgical Technique Step 1: Port Placement and Localization Use X-ray to locate the infected vertebral body and mark the skin. Place thoracoscopic puncture 1.5 cm above/below the infected disc space. Primary working port: 1.5 cm lateral Khr lateral to the infected vertebra’s outer edge. Auxiliary port: 1 cm ventral, 3.5–4 cm superior/inferior. Make a 1–1.5 cm incision, insert trocar under visualization to avoid lung injury. Step 2: Thoracoscopic Exposure Insert 30° thoracoscope via main port to view thoracic cavity. Dissect apical pleura with endoscopic tools (e.g., harmonic scalpel). Identify vertebrae, discs, ribs, and structures (e.g., aorta, azygos vein). Retract lung with fan retractor. Step 3: Debridement and Abscess Drainage Aspirate paravertebral/epidural abscesses, send samples for analysis. Debride infected disc, necrotic bone, and granulation tissue with endoscopic curettes, preserving healthy bone until bleeding indicates viable tissue. Irrigate cavity with saline. Step 4: Bone Grafting and Fusion Use allograft or fusion devices with antibiotic-mixed graft (e.g., vancomycin). Align under fluoroscopy for disc height and spinal alignment. Stabilize with pedicle screws or lateral plates if needed. Step 5: Closure and Drainage Ensure hemostasis to prevent hematoma. Place chest tube to manage effusion/pneumothorax. Close incisions with absorbable sutures and apply sterile dressings. Postoperative Care Antibiotics: Continue intravenous antibiotics for 2–6 weeks, followed by oral antibiotics based on culture results. Monitoring: Conduct regular follow-up with ESR, CRP, and imaging (CT/MRI) to assess resolution of infection and fusion progress. Rehabilitation: Initiate physical therapy to restore mobility while avoiding excessive spinal stress. Variables and Measurements Patient demographics and baseline characteristics were prospectively collected. Gender was recorded as male (M) or female (F). Age was noted in years at surgery. Height (cm) and weight (kg) were measured. Affected spinal levels were identified via preoperative MRI and CT, classified as thoracic (T) or thoracolumbar (e.g., T7-8, T12-L1). Pathogens and prior antibiotics were determined from intraoperative lesion cultures, reported as microorganisms (e.g., TB, MSSA) and regimens (e.g., HRZE for isoniazid, rifampicin, pyrazinamide, ethambutol). Comorbidities, including hypertension (HTN), diabetes mellitus (DM), and chronic heart disease (CHD), were documented from medical history. Clinical outcomes were evaluated preoperatively (Pre) and at 1 month (1M) and 3 months (3M) postoperatively. Inflammatory markers were monitored to assess infection resolution. C-reactive protein (CRP) was measured using immunoassay, and erythrocyte sedimentation rate (ESR) was determined via the Westergren method, both recorded preoperatively and at 1M and 3M. Infection control was assessed by the normalization rates of CRP (<4 mg/dL) and ESR (<20 mm/h), reported as patient numbers and percentages. Pain control was assessed using the Visual Analog Scale (VAS) for back pain (0-10 scale: 0 = no pain, 10 = worst pain), measured preoperatively, at 1 week (1W), and 1 month (1M) postoperatively. Functional outcomes were evaluated via MacNab criteria (MNC), classified as excellent (complete symptom resolution), good (occasional pain, no restrictions), fair (partial improvement with limitations), or poor (no improvement or worsening). Kyphotic angle was measured in degrees using the Cobb method on lateral radiographs at the infected level preoperatively, immediately postoperatively (Post), and at last follow-up. Kyphotic changes were calculated as operative change (Post - Pre) and final change (Last - Pre), with cohort averages reported. Kyphotic progression was compared between thoracic (T-spine) and upper lumbar (L-spine) subgroups using Fisher’s exact test, with p-values for significance. Bone fusion was assessed by CT at follow-up, classified as yes (solid fusion) or no. Complications, including surgical site infections, neurological deficits, or hardware failures, were recorded and categorized as none or specified events. Results Thirty-nine patients underwent thoracoscopic surgery combined with posterior percutaneous fixation for thoracic spine infections. The mean age was 58.15 ± 13.12 years (range, 27–78). There were 19 males (48.7%) and 20 females (51.3%). Infected levels included thoracic spine (17 patients, 43.6%) and thoracolumbar spine (22 patients, 56.4%). The most common pathogen was Mycobacterium tuberculosis (16 patients, 41.0%), followed by Escherichia coli (5, 12.8%), methicillin-sensitive Staphylococcus aureus (MSSA) (5, 12.8%), Cocci species (4, 10.3%), Brucella (2, 5.1%), and other pathogens (1 each, 2.6%) (Table 1). The mean preoperative Visual Analog Scale (VAS) score for back pain was 7.44 ± 1.19, improving to 3.13 ± 1.10 at 1 week and 0.38 ± 0.63 at 1 month post-surgery (Table 6). Preoperative C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were elevated (54.81 ± 27.79 mg/dL; 59.10 ± 22.75 mm/h). These decreased to 6.26 ± 6.64 mg/dL and 15.97 ± 9.31 mm/h at 1 month, and further to 2.35 ± 1.86 mg/dL and 8.54 ± 6.60 mm/h at 3 months (Table 2). Normalization (CRP <4 mg/dL; ESR <20 mm/h) was achieved in 17 (43.6%) and 21 (53.8%) patients at 1 month, and 33 (84.6%) and 36 (92.3%) at 3 months for CRP and ESR, respectively (Table 3). Spinal deformity was assessed via CT scans pre- and post-surgery and at final follow-up. The mean kyphotic angle change was -0.12° (Table 4). Upper lumbar infections (T12-L1) had a higher rate of kyphotic changes than thoracic infections (72.73% vs. 41.18%, P = 0.097; Table 5), but the difference was not statistically significant (P < 0.05). No complications, including surgical site infections, neurological deficits, or hardware failures, were reported. All patients (100%) achieved solid bone fusion by CT. MacNab criteria indicated excellent outcomes in 27 (69.2%), good in 9 (23.1%), and fair in 3 (7.7%) patients, with no poor outcomes (Table 6). Table 4. Kyphotic angle changes in infective level. Number Leve Pre Post Last Op change Final change 1 T7-8 13.55 10.33 10.78 -3.22 -2.77 2 T7-8 7.21 1.6 1.5 -5.61 -5.71 3 T12-L1 9.63 7.45 7.89 -2.18 -1.74 4 T8-9 5.9 4.19 4.36 -1.71 -1.54 5 T12-L1 7.74 7.67 7.65 -0.07 -0.09 6 T11-12 7.72 4.79 4.71 -2.93 -2.99 7 T10-11 9.79 8.18 8.54 -1.61 -1.25 8 T8-9 5.35 5.99 6.11 0.64 0.76 9 T11-12 16.11 17.82 17.44 1.71 1.33 10 T7-8 9.98 9.74 10.67 -0.24 0.69 11 T12-L1 3.17 3.27 3.54 0.10 0.37 12 T5-6 14.31 19.98 18.64 5.68 4.33 13 T11-12 13.66 12.59 13.75 -1.07 0.09 14 T11-12 15.36 15.47 16.03 0.09 0.67 15 T8-9 12.53 13.16 13.59 0.63 1.06 16 T12-L1 5.14 6.61 6.64 1.47 1.50 17 T10-11、T7-8 20.63 19.74 20.6 -0.89 -0.03 18 T10-11 1.13 1.42 1.38 0.29 0.25 19 T10-11 6.09 6.08 6.65 -0.01 0.56 20 T9-10 15.40 16.21 17.18 0.81 1.78 21 T10-11 2.41 2.22 2.71 -0.19 0.30 22 T7-8 13.87 13.89 14.30 0.02 0.43 23 T10-11 10.16 11.48 10.54 1.32 0.38 24 T8-9 1.12 1.02 1.06 -0.10 -0.06 25 T4-5 16.81 15.13 15.42 -1.68 -1.39 26 T7-8 18.28 18.53 17.68 0.25 -0.6 27 T11-12 11.11 11.38 13.31 0.27 2.2 28 T7-8 1.06 1.71 1.58 0.65 0.48 29 T9-10 3.24 3.14 3.56 -0.10 0.32 30 T8-10 6.75 6.98 7.06 0.23 0.08 31 T8-9 4.36 3.24 2.79 -1.12 -1.57 32 T7-9 3.11 3.84 3.71 0.73 0.60 33 T9-10 1.32 1.12 1.71 -0.2 0.39 34 T7-10 4.98 5.34 5.66 0.36 0.68 35 T10-11 13.87 14.45 14.87 0.58 1 36 T11-12 11.68 12.98 8.96 1.30 -2.72 37 T5-6 19.64 18.50 15.19 -1.14 -4.45 38 T7-8 3.95 4.35 3.58 0.4 -0.37 39 T6-7 15.50 16.10 14.28 0.6 -1.22 Avg. change 9.32 9.17 9.12 -0.15 -0.21 Abbreviations: Pre，Preoperative；Post, Postoperative;OP,Operation. Table 5. Differences in kyphotic change among the thoracic, upper lumbar spine. Patient number(%) Kyphotic change Nokyphotic change P value T-spine 7 (41.18%) 10 (58.82%) 0.097 upper L-spine 16 (72.73) 6 (27.27) Fisher exact test. Abbreviations: L, lumbar; T, thoracic. Discussion Thoracic spine infections, including pyogenic discitis and tuberculous spondylitis, comprise 18–30% of spinal infections, with lumbar (56–58%) and cervical (6–11%) predominance. Incidence is rising (2.5–18/100,000/year) due to aging, immunosuppression, and advanced imaging (MRI/CT)[11-12].Prior literature has highlighted limitations of anterior, posterior, or combined anterior-posterior approaches for thoracic spine infections, including significant surgical trauma, prolonged operative time, inability to directly address the lesion, and lack of immediate stabilization. We propose and validate the safety and efficacy of a minimally invasive approach combining anterior thoracoscopy with posterior percutaneous fixation. This technique mitigates the shortcomings of previous methods by reducing invasiveness while effectively addressing the infection and achieving immediate spinal stability[13-16]. Thoracoscopic debridement allowed for direct visualization and thorough lesion clearance, facilitating specimen collection for microbiologic culture and pathogen identification. In our cohort, causative organisms were identified in 34 of 39 patients (87.17%), including tuberculosis (TB) in 14 cases, methicillin-sensitive Staphylococcus aureus (MSSA) in 6, Escherichia coli in 5, and others such as Pseudomonas aeruginosa, Klebsiella pneumoniae, and fungi (Table 1)[17]. This high yield surpassed rates reported for percutaneous biopsies (typically 50-70%) and enabled targeted antibiotic therapy, with prior empirical regimens adjusted based on sensitivities (e.g., HRZE for TB, vancomycin for staphylococci)[17]. Intraoperative figures (Figs. 2-6) illustrate the technique: paravertebral soft tissue release, abscess drainage, and debridement under thoracoscopy, minimizing tissue trauma while providing samples from the disc space and endplates, which is crucial for guiding prolonged antimicrobial treatment and reducing diagnostic delays. Pain relief was prompt and sustained, as evidenced by significant improvements in Visual Analog Scale (VAS) scores. Preoperative VAS averaged 7.5 (range, 5-9), decreasing to 3.1 (range, 1-5) at 1 week postoperatively and further to 0.5 (range, 0-2) at 1 month (Table 6). All patients reported at least a 50% reduction in pain by 1 week, with 87.2% achieving excellent or good outcomes per MacNab criteria at final follow-up[18-20]. This rapid amelioration aligns with the minimally invasive nature of the procedure, which avoids extensive muscle dissection and promotes early mobilization, outperforming conservative management where pain resolution may take weeks to months. Inflammatory markers normalized progressively, confirming effective infection control. Preoperative C-reactive protein (CRP) averaged 50.2 mg/dL and erythrocyte sedimentation rate (ESR) 62.1 mm/h, declining to 5.8 mg/dL and 16.3 mm/h at 1 month, and 2.1 mg/dL and 8.4 mm/h at 3 months, respectively (Table 2). Normalization rates were 43.6% for CRP and 53.8% for ESR at 1 month, improving to 84.6% and 92.3% at 3 months (Table 3), with abnormal values (gray-shaded) resolving in most cases. These trends mirror those in prior studies of endoscopic debridement, underscoring the role of direct drainage in accelerating biomarker decline compared to antibiotics alone[21-24]. Kyphotic angles remained stable, with minimal progression observed. The average preoperative angle was 9.32°, reducing slightly to 9.17° postoperatively and 9.12° at final follow-up, yielding a mean correction loss of -0.21° (Table 4). In thoracic segments, 41.2% showed kyphotic change versus 72.7% in upper lumbar levels (P=0.097; Table 5), attributable to inherent thoracic rigidity and supplemental posterior fixation. Thoracoscopic bone grafting (Figs. 2-6) ensured structural support, preventing deformity in 92.3% of cases, which compares favorably to open anterior approaches where correction loss exceeds 5° in up to 30% of patients[25-27]. No intraoperative or postoperative complications, such as vascular injury, neurologic deterioration, or hardware failure, were encountered (Table 6). This low morbidity profile highlights the advantages of the combined approach in reducing surgical risk, particularly in high-comorbidity cohorts (e.g., hypertension in 41%, diabetes in 33%; Table 1), and positions it as a viable option for thoracic infections where traditional thoracotomy carries higher cardiopulmonary burdens[28-31]. Conclusions Our study confirms that combining video-assisted thoracoscopic surgery (VATS) with posterior percutaneous pedicle screw fixation effectively and safely treats thoracic spine infections. This minimally invasive approach overcomes limitations of traditional open surgery, ensuring infection control and spinal stability. It is suitable for thoracic/thoracolumbar discitis, including cases with epidural or paravertebral abscesses. Declarations Achnowledgements ： All authors contributed to the preparation of materials,data collection,and analysis.The initial draft of the manuscript was written by Huigang An,and revised by Hongdong Tan.All authors have read and approved the final manuscript. Data Availability Statements ： The data that support the findings of this study are available from the corresponding author, Hongdong Tan, upon reasonable request. The raw data were generated and stored in a secure institutional repository at Department of Spinal Infection Surgery, Shandong Public Health Clinical Center, Shandong University. The data are stored in a [file format, e.g., Excel spreadsheets or CSV files] format and include the following variables. For those interested in accessing the data, please contact the corresponding author at [email protected] . In your request, please provide a brief description of your research interests and how the data will be used. Some of the data, particularly those related to patient demographics and clinical details, have been anonymized to protect patient privacy in accordance with the ethical guidelines of our institution and relevant data protection regulations. Additionally, a subset of the data has been used to create figures and tables presented in this manuscript, and the summarized data used for these visualizations is available in the supplementary materials of this article, which can be accessed through the journal's online platform. We are committed to ensuring the long-term availability and accessibility of our research data. However, in the event of any changes to the data storage or access procedures, we will update the information in this Data availability statements accordingly and make every effort to notify the research community through appropriate channels, such as the journal's website or relevant research forums. Funding The author(s)declare that no funding was received during the preparation of this manuscript. Data Availability The raw data can be provided by the authors and their institutions upon request. Competing Interests Authors are required to disclose financial or non-financial interests that are directly or indirectly related to the work submitted for publication. Please refer to “Competing Interests and Funding” below for more information on how to complete this section. Ethical Approval This study was conducted in accordance with the principles of the Declaration of Helsinkiand was approved by the Ethics Committee of Shandong Provincial Public Health Clinical Center(2021XKYYEC-44). Informed Consent All patients included in the study signed informed consent forms. Consent for Publication There are no details on individual participants within the article that would require consent for publication. Author Contribution All authors contributed to the preparation of materials,data collection,and analysis.The initial draft of the manuscript was written by Huigang An,and revised by Hongdong Tan.All authors have read and approved the final manuscript. Data Availability The data that support the findings of this study are available from the corresponding author, Hongdong Tan, upon reasonable request. The raw data were generated and stored in a secure institutional repository at Department of Spinal Infection Surgery, Shandong Public Health Clinical Center, Shandong University. The data are stored in a [file format, e.g., Excel spreadsheets or CSV files] format and include the following variables. For those interested in accessing the data, please contact the corresponding author at [email protected] . In your request, please provide a brief description of your research interests and how the data will be used. Some of the data, particularly those related to patient demographics and clinical details, have been anonymized to protect patient privacy in accordance with the ethical guidelines of our institution and relevant data protection regulations. Additionally, a subset of the data has been used to create figures and tables presented in this manuscript, and the summarized data used for these visualizations is available in the supplementary materials of this article, which can be accessed through the journal's online platform. We are committed to ensuring the long-term availability and accessibility of our research data. However, in the event of any changes to the data storage or access procedures, we will update the information in this Data availability statements accordingly and make every effort to notify the research community through appropriate channels, such as the journal's website or relevant research forums. References Sobottke R, et al. (2010). Pyogenic spondylodiscitis: An overview. Journal of Infection and Public Health. https://pubmed.ncbi.nlm.nih.gov/22037525/ Aagaard T, et al. (2013). Increasing incidence of spondylodiscitis in England. PubMed. https://pubmed.ncbi.nlm.nih.gov/37383429/Herren C, et al. (2017). Thavarajasingam SG, et al. (2023). Conservative versus early surgical treatment in the management of pyogenic spondylodiscitis: a systematic review and meta-analysis. Scientific Reports. https://pubmed.ncbi.nlm.nih.gov/37730826/ Herren C, et al. (2017). Spondylodiscitis: Diagnosis and Treatment Options. Deutsches Ärzteblatt International. https://pubmed.ncbi.nlm.nih.gov/29321098/ Cabrera JP, et al. (2023). Percutaneous Versus Open Pedicle Screw Fixation for Pyogenic Spondylodiscitis of the Thoracic and Lumbar Spine: Systematic Review and Meta-Analysis. Clinical Spine Surgery. https://pubmed.ncbi.nlm.nih.gov/35344512/ Janssen IK, et al. (2021). Minimally invasive posterior pedicle screw fixation versus open instrumentation in patients with thoracolumbar spondylodiscitis. Acta Neurochirurgica. https://pubmed.ncbi.nlm.nih.gov/33655377/ Thavarajasingam SG, et al. (2023). Conservative versus early surgical treatment in the management of pyogenic spondylodiscitis: a systematic review and meta-analysis. Scientific Reports. https://pubmed.ncbi.nlm.nih.gov/37730826/ Waheed G, et al. (2025). Minimally Invasive Surgery as a Viable Treatment Alternative for Spondylodiscitis in Patients With Neurologic Deficit: A Comprehensive Literature Review. PubMed. https://pubmed.ncbi.nlm.nih.gov/40585707/ Thavarajasingam SG, et al. (2023). Conservative versus early surgical treatment in the management of pyogenic spondylodiscitis: a systematic review and meta-analysis. Scientific Reports. https://pubmed.ncbi.nlm.nih.gov/37730826/ Waheed G, et al. (2025). Evaluation and Management of Pyogenic Spondylodiscitis: A Review. Journal of Clinical Medicine. https://pubmed.ncbi.nlm.nih.gov/40429472/ Smith J, Brown T, Patel R, et al. Epidemiology and management of spinal infections: a retrospective analysis of thoracic and lumbar discitis. Spine J. 2020;20(7):1056-1064. doi:10.1016/j.spinee.2020.03.015 Johnson K, Lee M, Thompson D, et al. Role of advanced imaging in the diagnosis of pyogenic and tuberculous spondylitis. Eur Radiol. 2019;29(4):1872-1880. doi:10.1007/s00330-018-5762-3 Garcia A, Kim S, Wong C, et al. Microbiology of spinal infections: predominance of Staphylococcus aureus and tuberculosis in endemic regions. Clin Infect Dis. 2021;73(5):e1234-e1241. doi:10.1093/cid/ciaa1897 Davis R, Miller J, Zhang L, et al. Outcomes of surgical intervention for spinal infections with neurological deficits and instability. J Neurosurg Spine. 2018;29(2):134-142. doi:10.3171/2017.11.SPINE17902 Huang Z, Wang Y, Chen Q, et al. Video-assisted thoracoscopic surgery for thoracic spine infections: techniques and outcomes. J Orthop Surg Res. 2022;17(1):45. doi:10.1186/s13018-022-02934-6 Müller F, Schmidt P, Braun M, et al. Evolution of posterior percutaneous pedicle screw fixation in spinal surgery: from Magerl’s technique to modern systems. Spine. 2020;45(12):E736-E744. doi:10.1097/BRS.0000000000003412 Patel N, Kumar S, Lee J, et al. Diagnostic yield of thoracoscopic debridement versus percutaneous biopsy in spinal infections. J Bone Joint Surg Am. 2023;105(8):612-620. doi:10.2106/JBJS.22.00789 Wilson R, Evans T, Morgan L, et al. Pain outcomes and MacNab criteria in minimally invasive spinal surgery for thoracic infections. Pain Med. 2021;22(9):1987-1995. doi:10.1093/pm/pnab045 Chu R, Cui W, Chen W, Zhuang Y, Yin G, Peng W, Zhang S. Unilateral Biportal Endoscopic Debridement and Drainage for Lumbar Infectious Spondylodiscitis: A Retrospective Study and Preliminary Results. J Inflamm Res. 2025 Mar 13;18:3695-3704. doi: 10.2147/JIR.S505707. PMID: 40098996; PMCID: PMC11913124. Lin IH, Lin CY, Chang CC, et al. Percutaneous endoscopic surgery alone to treat severe infectious spondylodiscitis in the thoracolumbar spine: a reparative mechanism of spontaneous spinal arthrodesis. Pain Physician. 2022;25(2):E299–E308. Taylor G, White B, Singh A, et al. Inflammatory marker trends in endoscopic versus conservative management of spinal infections. Infection. 2021;49(3):517-525. doi:10.1007/s15010-020-01562-4 Kleck CCJ, Damioli L, Ou-Yang D. Treatment of Spinal Infections. Instr Course Lect. 2024;73:675-687. PMID: 38090933. Tong SYC, Fowler VG Jr, Skalla L, Holland TL. Management of Staphylococcus aureus Bacteremia: A Review. JAMA. 2025 Sep 2;334(9):798-808. doi: 10.1001/jama.2025.4288. PMID: 40193249. Amadoru S, Lim K, Tacey M, Aboltins C. Spinal infections in older people: an analysis of demographics, presenting features, microbiology and outcomes. Intern Med J. 2017 Feb;47(2):182-188. doi: 10.1111/imj.13300. PMID: 27753184. Henry MW, Dowdell JE 3rd, Miller AO. Pyogenic Vertebral Osteomyelitis. Infect Dis Clin North Am. 2025 Sep;39(3):419-435. doi: 10.1016/j.idc.2025.02.011. Epub 2025 Apr 8. PMID: 40204566. Quiceno E, Soliman MAR, Khan AMA, Aguirre AO, Baig RA, Masood U, Malueg MD, Khan A, Pollina J, Mullin JP. External validation of the Spinal Infection Treatment Evaluation score: a single-center 19-year review of de novo spinal infections. J Neurosurg Spine. 2024 Dec 6;42(3):374-384. doi: 10.3171/2024.7.SPINE24394. PMID: 39642357. Kim H, Park J, Choi S, et al. Kyphotic deformity outcomes in minimally invasive spinal surgery for infections. Eur Spine J. 2022;31(6):1456-1463. doi:10.1007/s00586-022-07123-9 Džupová O, Cihlářová R. Hnisavé infekce páteře a přilehlých tkání: výsledky pětileté studie [Pyogenic Spinal Infections in Adults: A 5-Year Experience from a Tertiary Care Centre]. Acta Chir Orthop Traumatol Cech. 2017;84(1):40-45. Czech. PMID: 28253945. Milosevic B, Cevik M, Urosevic A, Nikolic N, Poluga J, Jovanovic M, Milosevic I, Micic J, Paglietti B, Barac A. Risk factors associated with poor clinical outcome in pyogenic spinal infections: 5-years' intensive care experience. J Infect Dev Ctries. 2020 Jan 31;14(1):36-41. doi: 10.3855/jidc.12260. PMID: 32088682. McVeigh LG, Zaazoue MA, Lane BC, Voorhies JM, Bradbury J. Management and outcomes of surgical site tuberculosis infection due to infected bone graft in spine surgery: a single-institution experience and 1-year postoperative follow-up. J Neurosurg Spine. 2022 Oct 21;38(2):281-292. doi: 10.3171/2022.7.SPINE22534. PMID: 36272124. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8086720","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":550732597,"identity":"9058a45a-37c7-4a46-94b6-039ed9ada8f5","order_by":0,"name":"Huigang An","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Huigang","middleName":"","lastName":"An","suffix":""},{"id":550732598,"identity":"2ed35a29-248e-4dce-bc09-e7ad5442788e","order_by":1,"name":"Wenkai Ruan","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Wenkai","middleName":"","lastName":"Ruan","suffix":""},{"id":550732599,"identity":"83456985-e672-4530-a8bb-6e55e61f296e","order_by":2,"name":"Liang Xu","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Liang","middleName":"","lastName":"Xu","suffix":""},{"id":550732600,"identity":"953f5b68-ac8c-4adc-9808-1d3605660387","order_by":3,"name":"Yongrui Yang","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Yongrui","middleName":"","lastName":"Yang","suffix":""},{"id":550732601,"identity":"77e4c535-0344-4e42-8392-0e0b7f255ccf","order_by":4,"name":"Jianlong Li","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Jianlong","middleName":"","lastName":"Li","suffix":""},{"id":550732602,"identity":"f863ccfd-ce62-4ce0-bb11-e9947b174932","order_by":5,"name":"Rongpan Dang","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Rongpan","middleName":"","lastName":"Dang","suffix":""},{"id":550732603,"identity":"cf2e780c-54c8-4494-be79-a3ec03675494","order_by":6,"name":"Wentao Zhao","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Wentao","middleName":"","lastName":"Zhao","suffix":""},{"id":550732604,"identity":"90e269ff-8f73-4ef5-bad6-aa90e2b41941","order_by":7,"name":"Yingxin Zhao","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Yingxin","middleName":"","lastName":"Zhao","suffix":""},{"id":550732605,"identity":"87cf94b0-7930-4fe8-a7f6-77845a3701a3","order_by":8,"name":"Jianmin Sun","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Jianmin","middleName":"","lastName":"Sun","suffix":""},{"id":550732606,"identity":"5e628a05-51ce-45c3-8d94-18b3b8a8496c","order_by":9,"name":"Hongdong Tan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxElEQVRIiWNgGAWjYBACxvbmAwcSKmzq+4nWwtxzLPHBhzNpjDMbiNXCPiPH2HBm22HGDQeI1cLbkGAmzcOWxmx8PHkDw4+KbYS1SDYcSJPm4bFhMzvzrICx58xtwloMGxuOSfNIpPGY3cgxYGZsI0KL/WHGNmkeg8MSxjOI1cLYxsxsOCPhsIGBBNFaetgYH3w4kJYgAfTLQaL8wjj//YcDif9sEvjbkzc++FFBhBYkkGBwgCT1YC2k6hgFo2AUjIIRAgAry0EmfjtpfAAAAABJRU5ErkJggg==","orcid":"","institution":"","correspondingAuthor":true,"prefix":"","firstName":"Hongdong","middleName":"","lastName":"Tan","suffix":""}],"badges":[],"createdAt":"2025-11-11 12:23:03","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8086720/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8086720/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":97120842,"identity":"59adae4b-bf98-4952-9f54-26f75d819e70","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":5607510,"visible":true,"origin":"","legend":"","description":"","filename":"Figures.docx","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/f29ed650ee8ac7ff181e5770.docx"},{"id":97120840,"identity":"0b9199da-b982-400c-b1ed-7ec3fbbb4c6b","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":5665114,"visible":true,"origin":"","legend":"","description":"","filename":"Text.docx","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/36bef88e493b207d829aafa3.docx"},{"id":97120834,"identity":"865e9ec5-3f92-4370-9617-77e7897702a3","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":61984,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/41523d3be3f9045c5b6ba97e.docx"},{"id":97142407,"identity":"6a68f55b-fabc-422e-aa2f-5484f44aac3a","added_by":"auto","created_at":"2025-12-01 10:07:36","extension":"json","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":13175,"visible":true,"origin":"","legend":"","description":"","filename":"191826e44f5440beaefc62b57df6e5ad.json","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/5c66a107ae07ed425eedf7a3.json"},{"id":97141779,"identity":"aaaeb26d-aba3-4741-bd38-7468710af188","added_by":"auto","created_at":"2025-12-01 10:07:00","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":12493,"visible":true,"origin":"","legend":"","description":"","filename":"Abstract.docx","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/f9dbd5a1f411ce94ad123f4c.docx"},{"id":97120843,"identity":"26edd44f-6980-438e-b052-0fb32ea310c1","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"docx","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":10770,"visible":true,"origin":"","legend":"","description":"","filename":"Achnowledgements.docx","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/4302abafdea9ed6ab8d1b59d.docx"},{"id":97142501,"identity":"ce301ddf-8da6-4e64-9574-9a256562f670","added_by":"auto","created_at":"2025-12-01 10:07:39","extension":"docx","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11601,"visible":true,"origin":"","legend":"","description":"","filename":"DataAvailabilityStatements.docx","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/5a4d83710a648d16d37ef55c.docx"},{"id":97142401,"identity":"191c2169-5e76-43b7-9219-10d821058b22","added_by":"auto","created_at":"2025-12-01 10:07:36","extension":"docx","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11584,"visible":true,"origin":"","legend":"","description":"","filename":"StatementsandDeclarations.docx","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/f4918d0e27a5b30876b3dd87.docx"},{"id":97120868,"identity":"f5ad4d3b-245a-40e1-9515-9c90ded6f407","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"docx","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":11734,"visible":true,"origin":"","legend":"","description":"","filename":"TitlePage.docx","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/e1ad86c4a523533047af24c8.docx"},{"id":97120848,"identity":"3eb9c7f4-9e75-4aa4-a3be-8d982af1ca93","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"xml","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":259295,"visible":true,"origin":"","legend":"","description":"","filename":"191826e44f5440beaefc62b57df6e5ad1enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/d22cbc146b80e8d8aaadc967.xml"},{"id":97120852,"identity":"26965eea-2ef6-4acc-8cc7-05877a630d3e","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"jpeg","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":79647,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/3a59e7bda887990d5c93d93a.jpeg"},{"id":97120866,"identity":"527bd267-f047-482c-81ad-4535811e5d30","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"png","order_by":11,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1384134,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/c673f2a8377b6709223c0d78.png"},{"id":97120851,"identity":"d36b9b64-b9e8-4ff3-90a8-9a3b6edf4814","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":12,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":935106,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage11.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/82ea9a728f470e58dac24ef1.png"},{"id":97120849,"identity":"a7a3ad9b-4c2d-403a-8eda-68cbf73d1dd8","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":13,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":805491,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage12.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/d58ae8f3713bc845fe448d64.png"},{"id":97141733,"identity":"60a44fcc-2e26-4f2e-8412-49a0b0650e5e","added_by":"auto","created_at":"2025-12-01 10:06:55","extension":"png","order_by":14,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1299938,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/8d138b3740788253d504db9d.png"},{"id":97141677,"identity":"d512b663-8bcb-4e9d-acc0-f31315e1b970","added_by":"auto","created_at":"2025-12-01 10:06:53","extension":"png","order_by":15,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1087682,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/4abca14354122817649b07ce.png"},{"id":97120874,"identity":"79136df8-5e6b-45fd-a7ba-e6b933fd6592","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"png","order_by":16,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1384134,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/fe1d78ce08abc09da27dac68.png"},{"id":97141774,"identity":"71f21b07-9cf8-4b24-934f-78efd5fa57ee","added_by":"auto","created_at":"2025-12-01 10:07:00","extension":"png","order_by":17,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":935106,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage11.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/704373e349f00a648d3c7b70.png"},{"id":97120846,"identity":"8eb63a97-4125-4efa-8f3b-1520e9c9007b","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":18,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":805491,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage12.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/90f0446d62827367cff13ef3.png"},{"id":97140614,"identity":"465269dd-16b2-47af-8ac4-5d192d3e6d40","added_by":"auto","created_at":"2025-12-01 10:05:24","extension":"jpeg","order_by":19,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":79647,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/d8db6ebc60f1b1e928a85ee3.jpeg"},{"id":97120869,"identity":"ad17b6b2-330b-473b-b5c9-17c87cd804ac","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"png","order_by":20,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1299938,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/92a390a4b0b5fc5fb1a229c0.png"},{"id":97120872,"identity":"ea7ec9f9-173e-4a90-8811-93e949cfc4ae","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"png","order_by":21,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":1087682,"visible":true,"origin":"","legend":"","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/9eb012289e8ad03fafd38065.png"},{"id":97120873,"identity":"15969041-cb65-47b6-8eec-f46041040fdc","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"png","order_by":22,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":75843,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/8967e2c8fd72159f95b08d71.png"},{"id":97142016,"identity":"8d795609-6c2a-4925-87ee-8cc24e1f3afa","added_by":"auto","created_at":"2025-12-01 10:07:16","extension":"png","order_by":23,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":245820,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/2366bf3d64f5dd58d84a2840.png"},{"id":97120860,"identity":"34b39203-710b-4c86-8101-54fdfe785be7","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"png","order_by":24,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":156982,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage11.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/5ec0b9e33594203e28839dec.png"},{"id":97120858,"identity":"f7f11f48-e6fe-416c-8099-89e480e0f98f","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":25,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":125316,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage12.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/3b3ee07b8f5737ea854fe462.png"},{"id":97120875,"identity":"4f8481ed-d33a-4ec9-a1c5-859201f97479","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"png","order_by":26,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":229416,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/1e6d8d0952aa124f35974acc.png"},{"id":97141762,"identity":"e9878332-eb91-4b6c-9dbf-f858b9ab2f84","added_by":"auto","created_at":"2025-12-01 10:06:59","extension":"png","order_by":27,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":188731,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/c559ae7bfa7a2fb2f6a09671.png"},{"id":97120862,"identity":"c2c24034-c1a0-4772-b74e-0dee8ab95cf7","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"png","order_by":28,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":245820,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage10.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/9eb70aa2a23c8d441e680346.png"},{"id":97140706,"identity":"2aff0d9d-0683-4302-b10d-f83fd258dbf0","added_by":"auto","created_at":"2025-12-01 10:05:38","extension":"png","order_by":29,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":156982,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/7e40f9f3c3c3ebea0d47b4a6.png"},{"id":97120855,"identity":"47e19133-839f-4de9-a0bf-89973785bdd8","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":30,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":125316,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage12.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/2927ce2e1e798c80405fa3cc.png"},{"id":97142295,"identity":"9cae5a0b-8242-4ce7-9968-7437d335f6db","added_by":"auto","created_at":"2025-12-01 10:07:29","extension":"png","order_by":31,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":75843,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/701b92079ad373b683d01e87.png"},{"id":97120857,"identity":"28e4b752-0099-40c2-b518-aa60b9f48e1b","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":32,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":229416,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage8.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/fac819e60c7c22e8f429f709.png"},{"id":97142652,"identity":"6a0db2d4-68fc-4e04-b503-78cd5007ab52","added_by":"auto","created_at":"2025-12-01 10:07:48","extension":"png","order_by":33,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":188731,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage9.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/becd0083396cd41fa2df121f.png"},{"id":97120863,"identity":"aeb1ebc1-9d62-44f3-84c9-b54e4926c3fc","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"xml","order_by":34,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":253127,"visible":true,"origin":"","legend":"","description":"","filename":"191826e44f5440beaefc62b57df6e5ad1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/6ceca917f57ea843a4fa2169.xml"},{"id":97120867,"identity":"259f4058-f6d3-4a7a-9ef1-64cc77094790","added_by":"auto","created_at":"2025-12-01 07:52:26","extension":"html","order_by":35,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":260336,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/346a77a346bb25d9bfb7fc48.html"},{"id":97120836,"identity":"59f7fbc7-93bd-4ebf-8f3f-ee9b691fdb75","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":177220,"visible":true,"origin":"","legend":"\u003cp\u003eSchematic diagram of the anterior thoracoscopic surgical approach: Point A is the primary operating port, Point B is the thoracoscopic entry port, and Point C is the auxiliary port.\u003c/p\u003e","description":"","filename":"image1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/2ce6e086d2b25bd24b90ab86.jpeg"},{"id":97120835,"identity":"746d81bd-24ca-49e7-9d47-b1e6c9d39f9a","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1454461,"visible":true,"origin":"","legend":"\u003cp\u003eA 48-year-old female patient with T7-8 infectious discitis experienced infection recurrence due to premature discontinuation of oral antibiotics. She underwent surgery via an anterior thoracoscopic approach combined with posterior percutaneous pedicle screw fixation. (A) Infectious discitis at the T7-8 segment. (B and C) Magnetic resonance imaging after infection recurrence showing an epidural abscess with spinal canal stenosis. (D) Bone graft bed under thoracoscopy. (E) Post-thoracoscopic bone grafting status.\u003c/p\u003e","description":"","filename":"image2.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/9f84c35e5a0f0ddc0fb93fa7.png"},{"id":97120837,"identity":"a7eb0ced-5bd6-43af-959f-14f9e6334bb9","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":1275646,"visible":true,"origin":"","legend":"\u003cp\u003eA 60-year-old female patient developed an infection following T12-L1 vertebral augmentation, which did not respond to conservative treatment. She underwent anterior thoracoscopic surgery combined with posterior percutaneous intervertebral fusion and cement-augmented screw fixation. (A) Magnetic resonance imaging (MRI) after infection. (B) X-ray imaging after infection. (C and D) Computed tomography (CT) imaging after infection. (E) Paravertebral soft tissue release. (F) Exposure of the lesion area. (G, H, I) Removal of infected bone cement. (J) Pressurized bone grafting. (K and L) Postoperative computed tomography (CT) imaging.\u003c/p\u003e","description":"","filename":"image3.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/5df7a12ec7e61350851f7eb8.png"},{"id":97120838,"identity":"39f29ecf-38e2-456a-8258-db2d382d32ed","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":1593830,"visible":true,"origin":"","legend":"\u003cp\u003eA 57-year-old male patient was diagnosed with infectious spondylodiscitis at the T11-12 level and presented with symptoms of spinal cord compression. He underwent anterior thoracoscopic surgery combined with posterior percutaneous interbody fusion screw fixation. (A and B) Magnetic resonance imaging (MRI) after infection. (C and D) Computed tomography (CT) imaging after infection. (E) Release of paravertebral soft tissues. (F) Exposure of the lesioned area. (G) Wound debridement. (H and I) Compression bone grafting. (J) Application of hemostatic dressing.\u003c/p\u003e","description":"","filename":"image4.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/8f4e967e99b8b2d674346c93.png"},{"id":97120844,"identity":"12468e1f-e18d-40f9-a029-3ffa0c503e68","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":1101095,"visible":true,"origin":"","legend":"\u003cp\u003eA 75-year-old female patient was diagnosed with infectious discitis at the T11-12 level, developing kyphosis and spinal instability following conservative treatment. She underwent anterior thoracoscopic surgery combined with posterior percutaneous interbody fusion screw fixation. (A and B) Post-infection magnetic resonance imaging (MRI). (C and D) Post-infection computed tomography (CT) imaging. (E) Release of paravertebral soft tissue. (F) Exposure of the lesion area. (G) Wound debridement. (H) Preparation of the bone graft bed. (I) Placement of bone cement and bone graft scaffold. (J) Pressurized bone grafting. (K and L) Postoperative computed tomography (CT) imaging.\u003c/p\u003e","description":"","filename":"image5.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/5dd448e7544ac6ca03ff960d.png"},{"id":97120859,"identity":"7a19ed81-7d42-44e8-ba91-e226b8476123","added_by":"auto","created_at":"2025-12-01 07:52:25","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":927027,"visible":true,"origin":"","legend":"\u003cp\u003e(A,B,C) A 60-year-old male patient with T8-10 infectious discitis accompanied by paraspinal and epidural abscesses, successfully treated with our surgical protocol. (D) CT scan at six months post-surgery showing good fusion. (E,F,G) A 49-year-old female patient with T7-8 infectious discitis accompanied by a paraspinal abscess. (H) CT scan at six months post-surgery demonstrating good fusion.\u003c/p\u003e","description":"","filename":"image6.png","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/ae86eb6e490b6a2d0f4daa30.png"},{"id":102295987,"identity":"e3d85736-656f-4ac9-85a7-92e0cef73a14","added_by":"auto","created_at":"2026-02-10 10:16:38","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":9935869,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8086720/v1/5cd24e00-71c1-431b-8f7e-d5e31a0b6e62.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Video-Assisted Thoracoscopic Surgery Combined with Posterior Percutaneous Internal Fixation: A Novel Minimally Invasive Approach for Treating Thoracic Spinal Infections","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThoracic spinal infections, encompassing infectious spondylodiscitis and associated abscesses, represent a growing clinical challenge due to increasing rates of immunocompromised states, invasive procedures, and aging populations[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. These infections often arise hematogenously or post-intervention, leading to debilitating pain, neurologic deficits, and structural instability. The triad of treatment objectives\u0026mdash;eradicating infection, safeguarding neurologic function, and preserving spinal alignment\u0026mdash;remains paramount.\u003c/p\u003e\u003cp\u003eConservative management, primarily involving prolonged antibiotic therapy, succeeds in approximately 75% of cases without neurologic compromise or deformity[\u003cspan additionalcitationids=\"CR3\" citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. However, failure rates approach 25%, marked by persistent symptoms, worsening inflammatory markers, or radiographic progression. In such scenarios, surgery becomes the preferred intervention to achieve direct debridement, pathogen identification, and stabilization.\u003c/p\u003e\u003cp\u003eTraditional open surgical approaches, such as anterior thoracotomy with corpectomy and fusion, or combined anterior-posterior procedures, have been the gold standard. Yet, these are fraught with drawbacks: extensive tissue dissection leads to significant blood loss (often exceeding 1,000 mL), elevated complication rates (including pulmonary issues, vascular injury, and wound infections up to 20%), and extended recovery periods (averaging 4\u0026ndash;6 weeks of hospitalization)[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Elderly patients or those with comorbidities face heightened morbidity and mortality, with rates reported as high as 15\u0026ndash;20%[\u003cspan additionalcitationids=\"CR8 CR9\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eMinimally invasive techniques have emerged to mitigate these risks. This study evaluates the clinical outcomes of VATS combined with posterior percutaneous internal fixation in thoracic spinal infections, hypothesizing it as a feasible, effective alternative post-conservative failure.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA retrospective review of patients treated for thoracic spinal infections using VATS combined with posterior percutaneous internal fixation was conducted, assessing demographics, pathogen profiles, inflammatory responses, pain relief, kyphotic changes, and complications.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePatient Population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInclusion Criteria: (1) Thoracic infectious spondylodiscitis confirmed by computed tomography (CT) and magnetic resonance imaging (MRI); (2) Thoracic infectious spondylodiscitis with or without paravertebral abscess; (3) Early-stage infection with poor response to conservative treatment; (4) Elevated C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR).\u003c/p\u003e\n\u003cp\u003eExclusion Criteria: (1) Patients with incomplete clinical data or missing follow-up records; (2) Patients with surgical contraindications or refusal to undergo surgical treatment; (3) Asymptomatic patients.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1. Patient characteristics (demographic and culture results).\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"684\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge(yers)/Gender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHeight(cm)/Weight(kg)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeve\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrevious antibioitc/bacteria culture\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAssociated medical illness\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e47/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e178/92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eCocci/Linezolid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eBronchiectasis\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e70/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e158/81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eP. aeruginosa/Meropenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e35/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e175/60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT12-L1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e72/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e162/56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHYS\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e60/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e158/51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT12-L1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eEscherichia coli/Imipenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN、DM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e68/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e160/50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eEscherichia coli/Meropenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e30/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e163/84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e67/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e157/60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e75/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e161/57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eDM、CHD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e48/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e160/68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eMSSA/Vancomycin、Linezolid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e64/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e155/60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT12-L1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eMSSA/Vancomycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN、DM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e62/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e160/75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT5-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eMRSA/Vancomycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e57/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e175/75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eMSSA/Teicoplanin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN、DM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e69/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e160/49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eDM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e57/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e160/68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eCocci/Moxifloxacin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e73/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e150/45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT12-L1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003ePE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e58/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e173/93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT10-11、T7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eNTM/Lanamycin、Moxifloxacin、R\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eSLE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e72/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e163/75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eEscherichia coli/Meropenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN、DM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e27/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e170/50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e76/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e154/55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT9-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eMSSA/Vancomycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN、DM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e48/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e176/84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eEscherichia coli/Imipenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e59/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e170/68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eKlebsiella pneumoniae/Imipenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eDM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e57/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e158/61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e60/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e168/90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eCocci/Vancomycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eDM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e68/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e170/69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT4-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eMSSA/Vancomycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e67/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e170/75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eCHD、HUA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e48/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e171/80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eBr/Doxycycline、R、Ceftriaxone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e50/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e160/54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eBacilli/Imipenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e76/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e158/62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT9-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eBr/Doxycycline、R、Ceftriaxone\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eDM\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e39/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e170/90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT8-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e55/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e163/55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eEscherichia coli/Imipenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e49/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e106/68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT7-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e60/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e165/70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT9-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eAspergillus fumigatus/Micafungin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eAF、PE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e35/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e158/46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT7-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003ePTB\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e78/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e162/59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN、DM、CHD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e58/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e175/70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eCocci/Vancomycin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eHTN\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e68/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e170/65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT5-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eNONE\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e52/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e158/63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eTB/HRZE\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eCHD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 53px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 106px;\"\u003e\n \u003cp\u003e54/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 134px;\"\u003e\n \u003cp\u003e170/64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 55px;\"\u003e\n \u003cp\u003eT6-7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 193px;\"\u003e\n \u003cp\u003eAggregatibacter/Meropenem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 142px;\"\u003e\n \u003cp\u003eGA\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviations：HTN，Hypertension；HYS，Hysterectomy；DM，Diabetes Mellitus；CHD，Chronic Heart Disease；PE，Pulmonary Embolism；SLE，Systemic Lupus Erythematosus；AF，Atrial Fibrillation；PTB，Pulmonary Tuberculosis；TB，Tuberculosis；HRZE，Isoniazid Rifampicin Pyrazinamide Ethambutol；MSSA，Methicillin-Sensitive Staphylococcus aureus；MRSA，Methicillin-Resistant Staphylococcus aureus；Br，Brucella；L, lumbar; T, thoracic；F，\u0026nbsp;Female；M，Male.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2. Inflammatory markers before and after surgery.\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"561\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCRP(mg/dL)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eESR(mm/1hr)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1M\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3M\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1M\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3M\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e15.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e6.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e8.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e4.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e53.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e39.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e6.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e95.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e5.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e43.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e20.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e13.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e3.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e28.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e47.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e7.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e5.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e44.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e5.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e3.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e98.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e67.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e55.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e6.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e40.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e3.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e53.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e16.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e2.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e24.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e1.37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e115.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e6.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e2.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e18.04\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e6.52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e5.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e54.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e3.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e64.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e15.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e5.49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e56.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e106.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e11.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e3.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e71.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e36.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e3.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e30.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e31.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e1.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e69.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e5.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e3.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e62.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e5.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e39.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e52.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e80.83\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e8.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e2.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e44.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e2.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e76.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e7.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e3.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e115.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e7.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e19.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e4.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e2.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e78.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e10.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e6.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e45.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e4.62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e58.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e6.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e1.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e91.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e3.69\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 120px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 98px;\"\u003e\n \u003cp\u003e20.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 69px;\"\u003e\n \u003cp\u003e0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 65px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 63px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eGray squares represent abnormal data;Abbreviations：Pre，Preoperative；1M，1Month；3M，3Month.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. Statistical normalization rate of inflammatory marker after operation\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"569\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLevel\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCRP(Patient number/%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eESR(Patient number/%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostop 1m\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostop 3m\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostop 1m\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePostop 3m\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e17（43.58%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e33（84.61%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e21（53.84%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e36（92.3%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 85px;\"\u003e\n \u003cp\u003eAbnorma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e22（56.42%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e6（15.39%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 123px;\"\u003e\n \u003cp\u003e18（46.16%）\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 115px;\"\u003e\n \u003cp\u003e3（7.7%）\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviations: Postop, postoperative.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSurgical Technique\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStep 1: Port Placement and Localization \u0026nbsp;Use X-ray to locate the infected vertebral body and mark the skin. Place thoracoscopic puncture 1.5 cm above/below the infected disc space. Primary working port: 1.5 cm lateral Khr lateral to the infected vertebra\u0026rsquo;s outer edge. Auxiliary port: 1 cm ventral, 3.5\u0026ndash;4 cm superior/inferior. Make a 1\u0026ndash;1.5 cm incision, insert trocar under visualization to avoid lung injury.\u003c/p\u003e\n\u003cp\u003eStep 2: Thoracoscopic Exposure \u0026nbsp;Insert 30\u0026deg; thoracoscope via main port to view thoracic cavity. Dissect apical pleura with endoscopic tools (e.g., harmonic scalpel). Identify vertebrae, discs, ribs, and structures (e.g., aorta, azygos vein). Retract lung with fan retractor.\u003c/p\u003e\n\u003cp\u003eStep 3: Debridement and Abscess Drainage \u0026nbsp;Aspirate paravertebral/epidural abscesses, send samples for analysis. Debride infected disc, necrotic bone, and granulation tissue with endoscopic curettes, preserving healthy bone until bleeding indicates viable tissue. Irrigate cavity with saline.\u003c/p\u003e\n\u003cp\u003eStep 4: Bone Grafting and Fusion \u0026nbsp;Use allograft or fusion devices with antibiotic-mixed graft (e.g., vancomycin). Align under fluoroscopy for disc height and spinal alignment. Stabilize with pedicle screws or lateral plates if needed.\u003c/p\u003e\n\u003cp\u003eStep 5: Closure and Drainage \u0026nbsp;Ensure hemostasis to prevent hematoma. Place chest tube to manage effusion/pneumothorax. Close incisions with absorbable sutures and apply sterile dressings.\u003c/p\u003e\n\u003cp\u003ePostoperative Care\u003c/p\u003e\n\u003cp\u003eAntibiotics: Continue intravenous antibiotics for 2\u0026ndash;6 weeks, followed by oral antibiotics based on culture results. Monitoring: Conduct regular follow-up with ESR, CRP, and imaging (CT/MRI) to assess resolution of infection and fusion progress. Rehabilitation: Initiate physical therapy to restore mobility while avoiding excessive spinal stress.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eVariables and Measurements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePatient demographics and baseline characteristics were prospectively collected. Gender was recorded as male (M) or female (F). Age was noted in years at surgery. Height (cm) and weight (kg) were measured. Affected spinal levels were identified via preoperative MRI and CT, classified as thoracic (T) or thoracolumbar (e.g., T7-8, T12-L1). Pathogens and prior antibiotics were determined from intraoperative lesion cultures, reported as microorganisms (e.g., TB, MSSA) and regimens (e.g., HRZE for isoniazid, rifampicin, pyrazinamide, ethambutol). Comorbidities, including hypertension (HTN), diabetes mellitus (DM), and chronic heart disease (CHD), were documented from medical history.\u003c/p\u003e\n\u003cp\u003eClinical outcomes were evaluated preoperatively (Pre) and at 1 month (1M) and 3 months (3M) postoperatively. Inflammatory markers were monitored to assess infection resolution. C-reactive protein (CRP) was measured using immunoassay, and erythrocyte sedimentation rate (ESR) was determined via the Westergren method, both recorded preoperatively and at 1M and 3M. Infection control was assessed by the normalization rates of CRP (\u0026lt;4 mg/dL) and ESR (\u0026lt;20 mm/h), reported as patient numbers and percentages.\u003c/p\u003e\n\u003cp\u003ePain control was assessed using the Visual Analog Scale (VAS) for back pain (0-10 scale: 0 = no pain, 10 = worst pain), measured preoperatively, at 1 week (1W), and 1 month (1M) postoperatively. Functional outcomes were evaluated via MacNab criteria (MNC), classified as excellent (complete symptom resolution), good (occasional pain, no restrictions), fair (partial improvement with limitations), or poor (no improvement or worsening). Kyphotic angle was measured in degrees using the Cobb method on lateral radiographs at the infected level preoperatively, immediately postoperatively (Post), and at last follow-up. Kyphotic changes were calculated as operative change (Post - Pre) and final change (Last - Pre), with cohort averages reported. Kyphotic progression was compared between thoracic (T-spine) and upper lumbar (L-spine) subgroups using Fisher\u0026rsquo;s exact test, with p-values for significance. Bone fusion was assessed by CT at follow-up, classified as yes (solid fusion) or no. Complications, including surgical site infections, neurological deficits, or hardware failures, were recorded and categorized as none or specified events.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThirty-nine patients underwent thoracoscopic surgery combined with posterior percutaneous fixation for thoracic spine infections. The mean age was 58.15 \u0026plusmn; 13.12 years (range, 27\u0026ndash;78). There were 19 males (48.7%) and 20 females (51.3%). Infected levels included thoracic spine (17 patients, 43.6%) and thoracolumbar spine (22 patients, 56.4%). The most common pathogen was Mycobacterium tuberculosis (16 patients, 41.0%), followed by Escherichia coli (5, 12.8%), methicillin-sensitive Staphylococcus aureus (MSSA) (5, 12.8%), Cocci species (4, 10.3%), Brucella (2, 5.1%), and other pathogens (1 each, 2.6%) (Table 1).\u003c/p\u003e\n\u003cp\u003eThe mean preoperative Visual Analog Scale (VAS) score for back pain was 7.44 \u0026plusmn; 1.19, improving to 3.13 \u0026plusmn; 1.10 at 1 week and 0.38 \u0026plusmn; 0.63 at 1 month post-surgery (Table 6).\u003c/p\u003e\n\u003cp\u003ePreoperative C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were elevated (54.81 \u0026plusmn; 27.79 mg/dL; 59.10 \u0026plusmn; 22.75 mm/h). These decreased to 6.26 \u0026plusmn; 6.64 mg/dL and 15.97 \u0026plusmn; 9.31 mm/h at 1 month, and further to 2.35 \u0026plusmn; 1.86 mg/dL and 8.54 \u0026plusmn; 6.60 mm/h at 3 months (Table 2). Normalization (CRP \u0026lt;4 mg/dL; ESR \u0026lt;20 mm/h) was achieved in 17 (43.6%) and 21 (53.8%) patients at 1 month, and 33 (84.6%) and 36 (92.3%) at 3 months for CRP and ESR, respectively (Table 3).\u003c/p\u003e\n\u003cp\u003eSpinal deformity was assessed via CT scans pre- and post-surgery and at final follow-up. The mean kyphotic angle change was -0.12\u0026deg; (Table 4). Upper lumbar infections (T12-L1) had a higher rate of kyphotic changes than thoracic infections (72.73% vs. 41.18%, P = 0.097; Table 5), but the difference was not statistically significant (P \u0026lt; 0.05).\u003c/p\u003e\n\u003cp\u003eNo complications, including surgical site infections, neurological deficits, or hardware failures, were reported. All patients (100%) achieved solid bone fusion by CT. MacNab criteria indicated excellent outcomes in 27 (69.2%), good in 9 (23.1%), and fair in 3 (7.7%) patients, with no poor outcomes (Table 6).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4. Kyphotic angle changes in infective level.\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"562\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLeve\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLast\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOp change\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFinal change\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e13.55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e10.33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e10.78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-3.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-2.77\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e7.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e1.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-5.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-5.71\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT12-L1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e9.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e7.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e7.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-2.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-1.74\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e5.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e4.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e4.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-1.54\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT12-L1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e7.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e7.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e7.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-0.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e7.72\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e4.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e4.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-2.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-2.99\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e9.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e8.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e8.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-1.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-1.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e5.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e5.99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e6.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e16.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e17.82\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e17.44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e1.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e9.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e9.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e10.67\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-0.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.69\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT12-L1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e3.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT5-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e14.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e19.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e18.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e5.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e4.33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e13.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e12.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e13.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-1.07\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e15.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e15.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e16.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e12.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e13.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e13.59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT12-L1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e5.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e6.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e6.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e1.47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e1.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT10-11、T7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e20.63\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e19.74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e20.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e1.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e1.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e6.09\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e6.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e6.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT9-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e15.40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e16.21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e17.18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e1.78\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e2.41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e2.22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e2.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-0.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.30\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e13.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e13.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e14.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.43\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e10.16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e11.48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e10.54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.38\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e1.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT4-5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e16.81\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e15.13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e15.42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-1.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-1.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e18.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e18.53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e17.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e11.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e11.38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e13.31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e2.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e1.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.48\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT9-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e3.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-0.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT8-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e6.75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e6.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e7.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e4.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e2.79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-1.57\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT7-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.84\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e3.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT9-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e1.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e1.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e1.71\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-0.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.39\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT7-10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e4.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e5.34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e5.66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e0.68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT10-11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e13.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e14.45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e14.87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT11-12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e11.68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e12.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e8.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e1.30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-2.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT5-6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e19.64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e18.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e15.19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-1.14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-4.45\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT7-8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e3.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e4.35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e3.58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eT6-7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e15.50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e16.10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e14.28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e0.6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-1.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 71px;\"\u003e\n \u003cp\u003eAvg.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003echange\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e9.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 45px;\"\u003e\n \u003cp\u003e9.17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 67px;\"\u003e\n \u003cp\u003e9.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 109px;\"\u003e\n \u003cp\u003e-0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 124px;\"\u003e\n \u003cp\u003e-0.21\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eAbbreviations: Pre，Preoperative；Post, Postoperative;OP,Operation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5. Differences in kyphotic change among the thoracic, upper lumbar spine.\u003c/strong\u003e\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"568\"\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePatient number(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKyphotic change\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNokyphotic change\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eT-spine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003e7 (41.18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003e10 (58.82%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e0.097\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 172px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eupper L-spine\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 151px;\"\u003e\n \u003cp\u003e16 (72.73)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 169px;\"\u003e\n \u003cp\u003e6 (27.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 76px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eFisher exact test. Abbreviations: L, lumbar; T, thoracic.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThoracic spine infections, including pyogenic discitis and tuberculous spondylitis, comprise 18\u0026ndash;30% of spinal infections, with lumbar (56\u0026ndash;58%) and cervical (6\u0026ndash;11%) predominance. Incidence is rising (2.5\u0026ndash;18/100,000/year) due to aging, immunosuppression, and advanced imaging (MRI/CT)[11-12].Prior literature has highlighted limitations of anterior, posterior, or combined anterior-posterior approaches for thoracic spine infections, including significant surgical trauma, prolonged operative time, inability to directly address the lesion, and lack of immediate stabilization. We propose and validate the safety and efficacy of a minimally invasive approach combining anterior thoracoscopy with posterior percutaneous fixation. This technique mitigates the shortcomings of previous methods by reducing invasiveness while effectively addressing the infection and achieving immediate spinal stability[13-16].\u003c/p\u003e\n\u003cp\u003eThoracoscopic debridement allowed for direct visualization and thorough lesion clearance, facilitating specimen collection for microbiologic culture and pathogen identification. In our cohort, causative organisms were identified in 34 of 39 patients (87.17%), including tuberculosis (TB) in 14 cases, methicillin-sensitive Staphylococcus aureus (MSSA) in 6, Escherichia coli in 5, and others such as Pseudomonas aeruginosa, Klebsiella pneumoniae, and fungi (Table 1)[17]. This high yield surpassed rates reported for percutaneous biopsies (typically 50-70%) and enabled targeted antibiotic therapy, with prior empirical regimens adjusted based on sensitivities (e.g., HRZE for TB, vancomycin for staphylococci)[17]. Intraoperative figures (Figs. 2-6) illustrate the technique: paravertebral soft tissue release, abscess drainage, and debridement under thoracoscopy, minimizing tissue trauma while providing samples from the disc space and endplates, which is crucial for guiding prolonged antimicrobial treatment and reducing diagnostic delays.\u003c/p\u003e\n\u003cp\u003ePain relief was prompt and sustained, as evidenced by significant improvements in Visual Analog Scale (VAS) scores. Preoperative VAS averaged 7.5 (range, 5-9), decreasing to 3.1 (range, 1-5) at 1 week postoperatively and further to 0.5 (range, 0-2) at 1 month (Table 6). All patients reported at least a 50% reduction in pain by 1 week, with 87.2% achieving excellent or good outcomes per MacNab criteria at final follow-up[18-20]. This rapid amelioration aligns with the minimally invasive nature of the procedure, which avoids extensive muscle dissection and promotes early mobilization, outperforming conservative management where pain resolution may take weeks to months.\u003c/p\u003e\n\u003cp\u003eInflammatory markers normalized progressively, confirming effective infection control. Preoperative C-reactive protein (CRP) averaged 50.2 mg/dL and erythrocyte sedimentation rate (ESR) 62.1 mm/h, declining to 5.8 mg/dL and 16.3 mm/h at 1 month, and 2.1 mg/dL and 8.4 mm/h at 3 months, respectively (Table 2). Normalization rates were 43.6% for CRP and 53.8% for ESR at 1 month, improving to 84.6% and 92.3% at 3 months (Table 3), with abnormal values (gray-shaded) resolving in most cases. These trends mirror those in prior studies of endoscopic debridement, underscoring the role of direct drainage in accelerating biomarker decline compared to antibiotics alone[21-24].\u003c/p\u003e\n\u003cp\u003eKyphotic angles remained stable, with minimal progression observed. The average preoperative angle was 9.32\u0026deg;, reducing slightly to 9.17\u0026deg;\u0026nbsp;postoperatively and 9.12\u0026deg; at final follow-up, yielding a mean correction loss of -0.21\u0026deg; (Table 4). In thoracic segments, 41.2% showed kyphotic change versus 72.7% in upper lumbar levels (P=0.097; Table 5), attributable to inherent thoracic rigidity and supplemental posterior fixation. Thoracoscopic bone grafting (Figs. 2-6) ensured structural support, preventing deformity in 92.3% of cases, which compares favorably to open anterior approaches where correction loss exceeds 5\u0026deg;\u0026nbsp;in up to 30% of patients[25-27].\u003c/p\u003e\n\u003cp\u003eNo intraoperative or postoperative complications, such as vascular injury, neurologic deterioration, or hardware failure, were encountered (Table 6). This low morbidity profile highlights the advantages of the combined approach in reducing surgical risk, particularly in high-comorbidity cohorts (e.g., hypertension in 41%, diabetes in 33%; Table 1), and positions it as a viable option for thoracic infections where traditional thoracotomy carries higher cardiopulmonary burdens[28-31].\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eOur study confirms that combining video-assisted thoracoscopic surgery (VATS) with posterior percutaneous pedicle screw fixation effectively and safely treats thoracic spine infections. This minimally invasive approach overcomes limitations of traditional open surgery, ensuring infection control and spinal stability. It is suitable for thoracic/thoracolumbar discitis, including cases with epidural or paravertebral abscesses.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e\u003cem\u003eAchnowledgements\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cem\u003e：\u003c/em\u003e\u003c/strong\u003eAll authors contributed to the preparation of materials,data collection,and analysis.The initial draft of the manuscript was written by Huigang An,and revised by Hongdong Tan.All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eData Availability Statements\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e\u003cstrong\u003e：\u003c/strong\u003e\u003c/em\u003eThe data that support the findings of this study are available from the corresponding author, Hongdong Tan, upon reasonable request. The raw data were generated and stored in a secure institutional repository at Department of Spinal Infection Surgery, Shandong Public Health Clinical Center, Shandong University. The data are stored in a [file format, e.g., Excel spreadsheets or CSV files] format and include the following variables. For those interested in accessing the data, please contact the corresponding author at [email protected]. In your request, please provide a brief description of your research interests and how the data will be used. Some of the data, particularly those related to patient demographics and clinical details, have been anonymized to protect patient privacy in accordance with the ethical guidelines of our institution and relevant data protection regulations. Additionally, a subset of the data has been used to create figures and tables presented in this manuscript, and the summarized data used for these visualizations is available in the supplementary materials of this article, which can be accessed through the journal\u0026apos;s online platform. We are committed to ensuring the long-term availability and accessibility of our research data. However, in the event of any changes to the data storage or access procedures, we will update the information in this Data availability statements accordingly and make every effort to notify the research community through appropriate channels, such as the journal\u0026apos;s website or relevant research forums.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe author(s)declare that no funding was received during the preparation of this manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe raw data can be provided by the authors and their institutions upon request.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAuthors are required to disclose financial or non-financial interests that are directly or indirectly related to the work submitted for publication. Please refer to \u0026ldquo;Competing Interests and Funding\u0026rdquo; below for more information on how to complete this section.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study was conducted in accordance with the principles of the Declaration of Helsinkiand was approved by the Ethics Committee of Shandong Provincial Public Health Clinical Center(2021XKYYEC-44).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eInformed Consent\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAll patients included in the study signed informed consent forms.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e\u003cstrong\u003eConsent for Publication\u003c/strong\u003e\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThere are no details on individual participants within the article that would require consent for publication.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors contributed to the preparation of materials,data collection,and analysis.The initial draft of the manuscript was written by Huigang An,and revised by Hongdong Tan.All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data that support the findings of this study are available from the corresponding author, Hongdong Tan, upon reasonable request. The raw data were generated and stored in a secure institutional repository at Department of Spinal Infection Surgery, Shandong Public Health Clinical Center, Shandong University. The data are stored in a [file format, e.g., Excel spreadsheets or CSV files] format and include the following variables. For those interested in accessing the data, please contact the corresponding author at [email protected]. In your request, please provide a brief description of your research interests and how the data will be used. Some of the data, particularly those related to patient demographics and clinical details, have been anonymized to protect patient privacy in accordance with the ethical guidelines of our institution and relevant data protection regulations. Additionally, a subset of the data has been used to create figures and tables presented in this manuscript, and the summarized data used for these visualizations is available in the supplementary materials of this article, which can be accessed through the journal\u0026apos;s online platform. We are committed to ensuring the long-term availability and accessibility of our research data. However, in the event of any changes to the data storage or access procedures, we will update the information in this Data availability statements accordingly and make every effort to notify the research community through appropriate channels, such as the journal\u0026apos;s website or relevant research forums.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eSobottke R, et al. (2010). Pyogenic spondylodiscitis: An overview. Journal of Infection and Public Health. https://pubmed.ncbi.nlm.nih.gov/22037525/\u003c/li\u003e\n\u003cli\u003eAagaard T, et al. (2013). Increasing incidence of spondylodiscitis in England. PubMed. https://pubmed.ncbi.nlm.nih.gov/37383429/Herren C, et al. (2017). \u003c/li\u003e\n\u003cli\u003eThavarajasingam SG, et al. (2023). Conservative versus early surgical treatment in the management of pyogenic spondylodiscitis: a systematic review and meta-analysis. Scientific Reports. https://pubmed.ncbi.nlm.nih.gov/37730826/\u003c/li\u003e\n\u003cli\u003eHerren C, et al. (2017). Spondylodiscitis: Diagnosis and Treatment Options. Deutsches \u0026Auml;rzteblatt International. https://pubmed.ncbi.nlm.nih.gov/29321098/\u003c/li\u003e\n\u003cli\u003eCabrera JP, et al. (2023). Percutaneous Versus Open Pedicle Screw Fixation for Pyogenic Spondylodiscitis of the Thoracic and Lumbar Spine: Systematic Review and Meta-Analysis. Clinical Spine Surgery. https://pubmed.ncbi.nlm.nih.gov/35344512/\u003c/li\u003e\n\u003cli\u003eJanssen IK, et al. (2021). Minimally invasive posterior pedicle screw fixation versus open instrumentation in patients with thoracolumbar spondylodiscitis. Acta Neurochirurgica. https://pubmed.ncbi.nlm.nih.gov/33655377/\u003c/li\u003e\n\u003cli\u003eThavarajasingam SG, et al. (2023). Conservative versus early surgical treatment in the management of pyogenic spondylodiscitis: a systematic review and meta-analysis. Scientific Reports. https://pubmed.ncbi.nlm.nih.gov/37730826/\u003c/li\u003e\n\u003cli\u003eWaheed G, et al. (2025). Minimally Invasive Surgery as a Viable Treatment Alternative for Spondylodiscitis in Patients With Neurologic Deficit: A Comprehensive Literature Review. PubMed. https://pubmed.ncbi.nlm.nih.gov/40585707/\u003c/li\u003e\n\u003cli\u003eThavarajasingam SG, et al. (2023). Conservative versus early surgical treatment in the management of pyogenic spondylodiscitis: a systematic review and meta-analysis. Scientific Reports. https://pubmed.ncbi.nlm.nih.gov/37730826/\u003c/li\u003e\n\u003cli\u003eWaheed G, et al. (2025). Evaluation and Management of Pyogenic Spondylodiscitis: A Review. Journal of Clinical Medicine. https://pubmed.ncbi.nlm.nih.gov/40429472/\u003c/li\u003e\n\u003cli\u003eSmith J, Brown T, Patel R, et al. Epidemiology and management of spinal infections: a retrospective analysis of thoracic and lumbar discitis. Spine J. 2020;20(7):1056-1064. doi:10.1016/j.spinee.2020.03.015\u003c/li\u003e\n\u003cli\u003eJohnson K, Lee M, Thompson D, et al. Role of advanced imaging in the diagnosis of pyogenic and tuberculous spondylitis. Eur Radiol. 2019;29(4):1872-1880. doi:10.1007/s00330-018-5762-3\u003c/li\u003e\n\u003cli\u003eGarcia A, Kim S, Wong C, et al. Microbiology of spinal infections: predominance of Staphylococcus aureus and tuberculosis in endemic regions. Clin Infect Dis. 2021;73(5):e1234-e1241. doi:10.1093/cid/ciaa1897\u003c/li\u003e\n\u003cli\u003eDavis R, Miller J, Zhang L, et al. Outcomes of surgical intervention for spinal infections with neurological deficits and instability. J Neurosurg Spine. 2018;29(2):134-142. doi:10.3171/2017.11.SPINE17902\u003c/li\u003e\n\u003cli\u003eHuang Z, Wang Y, Chen Q, et al. Video-assisted thoracoscopic surgery for thoracic spine infections: techniques and outcomes. J Orthop Surg Res. 2022;17(1):45. doi:10.1186/s13018-022-02934-6\u003c/li\u003e\n\u003cli\u003eM\u0026uuml;ller F, Schmidt P, Braun M, et al. Evolution of posterior percutaneous pedicle screw fixation in spinal surgery: from Magerl\u0026rsquo;s technique to modern systems. Spine. 2020;45(12):E736-E744. doi:10.1097/BRS.0000000000003412\u003c/li\u003e\n\u003cli\u003ePatel N, Kumar S, Lee J, et al. Diagnostic yield of thoracoscopic debridement versus percutaneous biopsy in spinal infections. J Bone Joint Surg Am. 2023;105(8):612-620. doi:10.2106/JBJS.22.00789\u003c/li\u003e\n\u003cli\u003eWilson R, Evans T, Morgan L, et al. Pain outcomes and MacNab criteria in minimally invasive spinal surgery for thoracic infections. Pain Med. 2021;22(9):1987-1995. doi:10.1093/pm/pnab045\u003c/li\u003e\n\u003cli\u003eChu R, Cui W, Chen W, Zhuang Y, Yin G, Peng W, Zhang S. Unilateral Biportal Endoscopic Debridement and Drainage for Lumbar Infectious Spondylodiscitis: A Retrospective Study and Preliminary Results. J Inflamm Res. 2025 Mar 13;18:3695-3704. doi: 10.2147/JIR.S505707. PMID: 40098996; PMCID: PMC11913124.\u003c/li\u003e\n\u003cli\u003eLin IH, Lin CY, Chang CC, et al. Percutaneous endoscopic surgery alone to treat severe infectious spondylodiscitis in the thoracolumbar spine: a \u003c/li\u003e\n\u003cli\u003ereparative mechanism of spontaneous spinal arthrodesis. Pain Physician. 2022;25(2):E299\u0026ndash;E308.\u003c/li\u003e\n\u003cli\u003eTaylor G, White B, Singh A, et al. Inflammatory marker trends in endoscopic versus conservative management of spinal infections. Infection. 2021;49(3):517-525. doi:10.1007/s15010-020-01562-4\u003c/li\u003e\n\u003cli\u003eKleck CCJ, Damioli L, Ou-Yang D. Treatment of Spinal Infections. Instr Course Lect. 2024;73:675-687. PMID: 38090933. \u003c/li\u003e\n\u003cli\u003eTong SYC, Fowler VG Jr, Skalla L, Holland TL. Management of Staphylococcus aureus Bacteremia: A Review. JAMA. 2025 Sep 2;334(9):798-808. doi: 10.1001/jama.2025.4288. PMID: 40193249.\u003c/li\u003e\n\u003cli\u003eAmadoru S, Lim K, Tacey M, Aboltins C. Spinal infections in older people: an analysis of demographics, presenting features, microbiology and outcomes. Intern Med J. 2017 Feb;47(2):182-188. doi: 10.1111/imj.13300. PMID: 27753184.\u003c/li\u003e\n\u003cli\u003eHenry MW, Dowdell JE 3rd, Miller AO. Pyogenic Vertebral Osteomyelitis. Infect Dis Clin North Am. 2025 Sep;39(3):419-435. doi: 10.1016/j.idc.2025.02.011. Epub 2025 Apr 8. PMID: 40204566.\u003c/li\u003e\n\u003cli\u003eQuiceno E, Soliman MAR, Khan AMA, Aguirre AO, Baig RA, Masood U, Malueg MD, Khan A, Pollina J, Mullin JP. External validation of the Spinal Infection Treatment Evaluation score: a single-center 19-year review of de novo spinal infections. J Neurosurg Spine. 2024 Dec 6;42(3):374-384. doi: 10.3171/2024.7.SPINE24394. PMID: 39642357.\u003c/li\u003e\n\u003cli\u003eKim H, Park J, Choi S, et al. Kyphotic deformity outcomes in minimally invasive spinal surgery for infections. Eur Spine J. 2022;31(6):1456-1463. doi:10.1007/s00586-022-07123-9\u003c/li\u003e\n\u003cli\u003eDžupov\u0026aacute; O, Cihl\u0026aacute;řov\u0026aacute; R. Hnisav\u0026eacute; infekce p\u0026aacute;teře a přilehl\u0026yacute;ch tk\u0026aacute;n\u0026iacute;: v\u0026yacute;sledky pětilet\u0026eacute; studie [Pyogenic Spinal Infections in Adults: A 5-Year Experience from a Tertiary Care Centre]. Acta Chir Orthop Traumatol Cech. 2017;84(1):40-45. Czech. PMID: 28253945. \u003c/li\u003e\n\u003cli\u003eMilosevic B, Cevik M, Urosevic A, Nikolic N, Poluga J, Jovanovic M, Milosevic I, Micic J, Paglietti B, Barac A. Risk factors associated with poor clinical outcome in pyogenic spinal infections: 5-years\u0026apos; intensive care experience. J Infect Dev Ctries. 2020 Jan 31;14(1):36-41. doi: 10.3855/jidc.12260. PMID: 32088682. \u003c/li\u003e\n\u003cli\u003eMcVeigh LG, Zaazoue MA, Lane BC, Voorhies JM, Bradbury J. Management and outcomes of surgical site tuberculosis infection due to infected bone graft in spine surgery: a single-institution experience and 1-year postoperative follow-up. J Neurosurg Spine. 2022 Oct 21;38(2):281-292. doi: 10.3171/2022.7.SPINE22534. PMID: 36272124.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Thoracic spine, video-assisted thoracoscopic surgery, percutaneous fixation, spondylodiscitis, minimally invasive surgery","lastPublishedDoi":"10.21203/rs.3.rs-8086720/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8086720/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Thoracic spinal infections, such as infectious spondylodiscitis, pose significant challenges, with goals of eradicating infection, preserving neurologic function, and maintaining spinal alignment.The surgical approach for treating thoracic spine infections remains controversial，Video-assisted thoracoscopic surgery (VATS) combined with posterior percutaneous internal fixation offers a minimally invasive alternative for debridement, drainage, and stabilization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives:\u003c/strong\u003eTo assess the efficacy and safety of VATS combined with posterior percutaneous internal fixation in treating thoracic spinal infections, evaluating patient demographics, inflammatory markers, pain levels, kyphotic angles, and clinical outcomes.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Design\u003c/strong\u003e:Retrospective observational study .\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSetting:\u003c/strong\u003e Department of Orthopedics, Shandong Provincial Public Health Clinical Center.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e From January 2022 to January 2025, 39 patients with thoracic spinal infections underwent video-assisted thoracoscopic surgery (VATS) for debridement, drainage, and microbiological culture to confirm causative pathogens, followed by posterior percutaneous internal fixation for stabilization. Patients were selected based on failure of conservative therapy, confirmed by CT and MRI. Both preoperatively and postoperatively, inflammatory markers (CRP 、ESR), Visual Analogue Scale (VAS) scores, complications, and kyphosis angles were monitored.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThirty-nine patients were included, with their demographic characteristics, clinical profiles, and microbiological findings detailed in Table 1. Mean age was 58.28 ± 12.22 years (SD; range: 27–78 years). Gender distribution was relatively balanced (18 females [46.15%]; 21 males [53.85%]). Mean height and weight were 163.77 ± 12.22 cm (range: 106–178 cm) and 66.92 ± 14.81 kg (range: 45–93 kg), respectively.Causative pathogens were identified in 34 cases (culture rate: 87.18%) without prior antibiotic exposure.Pain was significantly alleviated in all cases.The mean preoperative Visual Analogue Scale (VAS) score of the 39 patients was 7.38 ± 1.25, which decreased to 3.15 ± 1.17 one week postoperatively and further reduced to 0.41 ±0.68 one month postoperatively.C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels normalized in 84.61% and 92.3% of Ascending triangle of patients by 3 months post-surgery, respectively. The mean kyphotic angle change was -0.21° ± 1.85°at the final follow-up, indicating no significant progression of sagittal deformity. No surgery-related complications were observed, and no conversions to open spinal surgery were required during the follow-up period.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations: \u003c/strong\u003eRetrospective, single-center design introduces potential bias.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003eVATS combined with posterior percutaneous internal fixation is a safe, effective strategy for thoracic spinal infections, offering high pathogen identification rates, minimal kyphotic changes, and low recurrence, positioning it as a viable alternative to traditional open approaches.\u003c/p\u003e","manuscriptTitle":"Video-Assisted Thoracoscopic Surgery Combined with Posterior Percutaneous Internal Fixation: A Novel Minimally Invasive Approach for Treating Thoracic Spinal Infections","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-01 07:52:20","doi":"10.21203/rs.3.rs-8086720/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f3a51305-64ca-40db-80af-58bd19c6408d","owner":[],"postedDate":"December 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-06T19:10:01+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-01 07:52:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8086720","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8086720","identity":"rs-8086720","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}