3. TREATMENT
Single-stage lateral rhachotomy and posterior spinal fusion with PPS
were performed. First, the PPS was inserted from T8–10 to L1–3 (Figure
4). The skin incisions for PPS installation were placed medial to the
common insertion point to avoid violating the posterolateral approach
for curettage. Each PPS was inserted perpendicularly to the body
surface. Posterolateral approaches to the T11–12 vertebral bodies were
performed bilaterally. An 8 cm longitudinal skin incision was made at
the center of the T12 transverse process, which was confirmed by
fluoroscopy. After costotransversectomy of T12, the lateral cortex of
the T12 vertebral body was exposed. Then, the cortex was drilled away by
a high-speed burr, and the infected lesion was curetted. The outside was
hard sclerotic bone, and the inside was scar tissue. The T11 vertebral
body and T11–12 intervertebral disc were also curetted. Finally,
autologous iliac bones were transplanted into the curetted area (Figure
5). A 5.5-mm-diameter titanium-alloy rod was percutaneously connected to
the PPS.