Thoracic vertebral lesion debridement through rib transverse process resection

Thoracic vertebrae debridement through rib transverse process is used for lesion clearance of spinal tuberculosis. Treating diseases: spinal tuberculosis Indication Thoracic vertebrae resection with rib transverse process is suitable for T410 vertebral tuberculosis, combined with paraspinal swelling and dead bone formation, or spinal cord compression. Contraindications 1. Active tuberculosis lesions in other parts of the body, such as invasive tuberculosis, tuberculous meningitis, etc., should be considered as surgical contraindications. However, surgical treatment can still be considered if the treatment is cured or stabilized. 2. After treatment with anti-tuberculosis drugs such as streptomycin, there is no improvement in symptoms of systemic poisoning. 3. Poor overall condition or infants, the elderly, and those who are difficult to tolerate surgery should suspend surgery and switch to other methods. Preoperative preparation Preoperative system for anti-tuberculosis drugs for 2 to 3 weeks to reduce or prevent the spread of intraoperative tuberculosis. Surgical procedure Incision A vertical incision was made 3 cm from the spinous process and was about 10 cm long. Cut the skin and deep fascia to reveal the trapezius and latissimus dorsi. 2. Reveal ribs and transverse processes Cut the oblique points of the trapezius, latissimus dorsi and deep rhomboid muscles along the direction of the incision, separate and cut off the attachment point of the sacral spine muscle in the transverse process, and pull it together with the above muscles to expose the ribs. Segments and transverse processes. 3. Cut the ribs and transverse processes According to the lesion, choose to remove the posterior segment of two ribs. Firstly, the periosteum is cut along the longitudinal direction of the rib, and the subperiosteal peeling is carefully performed. Be careful not to tear the pleura. Following, the corresponding transverse process is excised, the rib periosteum is removed from the rib bone neck, and the posterior segment of the rib is cut with the rib. Then the rib neck is cut and the rib is taken out, the intercostal vessels are ligated and the intercostal nerve is retained or cut. 4. Clear tuberculosis The pleura and soft tissue are carefully pushed forward along the vertebral body to reveal the anterior vertebral abscess and the vertebral body with lesions. First puncture the pus with a syringe, then cut the abscess wall longitudinally, completely suck out the pus, scrape the dead bone and granulation tissue. If combined with spinal cord compression, the lateral laminectomy should be performed first, and the ribs should be removed for fusion of the contralateral lamina, and then the tuberculosis lesions should be removed. 5. Close the incision After repeatedly washing the lesion with saline, put an appropriate amount of anti-tuberculosis drugs and antibiotics, and place a rubber sheet or cigarette to drain, suture the latissimus dorsi, trapezius and suture the skin incision.

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