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.