Mid- to short-term efficacy of Uniportal Video-Assisted Thoracoscopic Surgery in the treatment of thoracic spinal tuberculosis

BACKGROUND: Surgical treatment of thoracic spine tuberculosis using traditional procedures is often challenged by high trauma and slow recovery. This study aimed to investigate the short- and medium-term efficacy and safety of Uniportal Video-Assisted Thoracoscopic Surgery, a minimally invasive single-port thoracoscopy combined with posterior internal fixation for the treatment of thoracic spinal tuberculosis. METHODS: Nineteen patients with thoracic spinal tuberculosis (15 men and four women, mean age of 52 years) were retrospectively included. All patients underwent single-port thoracoscopic lesion removal and intervertebral implant fusion combined with posterior internal fixation. Surgical time, intraoperative bleeding volume, hospitalization time, and complications were recorded, and the rate of bone fusion and correction of the kyphosis angle were assessed using imaging, with a follow-up period of 6-12 months. RESULTS: All patients achieved postoperative bone fusion without serious complications. The average operative time was 149.58 min (75-212 min), the average intraoperative bleeding volume was 210.53 mL (50-600 mL), and the average hospital stay was 15.58 d (2-29 d). The mean thoracic kyphosis angle improved from 23.33° preoperatively to 19.00° at the final follow-up. CONCLUSIONS: Single-port thoracoscopic technique combined with posterior internal fixation can effectively remove thoracic tuberculosis foci and correct kyphosis deformity. Moreover, it has the advantages of less trauma, quicker recovery, and significant short- and medium-term efficacy, making it a feasible, minimally invasive surgical procedure for treating thoracic spinal tuberculosis. However, further optimizing the instrumentation design and expanding the sample size in the future is necessary to validate its long-term effects.