Wiltse TTIF approach for the treatment of single-segment thoracic spinal tuberculosis in the elderly with osteoporosis: a retrospective study of 20 cases

Background: This study aims to explore the clinical efficacy of Wiltse approach transforaminal thoracic interbody fusion (TTIF) for the treatment of single-segment thoracic spinal tuberculosis in elderly patients with and osteoporosis and neurological deficits. Methods: This is a retrospective analysis of 20 elderly patients who underwent Wiltse approach TTIF in our hospital from January 2017 to January 2019. The follow-up time was 37.15±7.37 months (range 24-48 months); and the preoperative kyphotic angle was 35.41±6.71°. The Frankel spinal cord injury classification was used to assess the degree of neurological deficit. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) are used to track the activity of tuberculosis (TB). While femoral neck bone mineral density measurement T value (BMD T) was used to assess the degree of osteoporosis. Result: The 20 elderly patients with spinal tuberculosis (STB) were completely cured without recurrence. The postoperative kyphotic angle was 8.80±0.79°, without significant loss of correction at the last follow-up. Bone graft fusion was observed within 6-9 months with all patients reporting that their back pains were relieved. The neurological condition of all patients improved after the operation. Conclusions: Wiltse TTIF treatment combined with anti-tuberculosis chemotherapy is adequate for obtaining satisfactory healing of single-segment thoracic tuberculosis in elderly patients with osteoporosis.