Clinical effects of treatment of single-segment lumbar tuberculosis by oblique lateral interbody fusion and percutaneous pedicle screw fixation

Chao Jiang; Si Yin; Weigong Zhao; Yingang Zhang; Xiaowei Zhang; Yimin Yang; Yongyuan Zhang; Chaoshuai Feng; Dingjun Hao; Heng DU

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Clinical effects of treatment of single-segment lumbar tuberculosis by oblique lateral interbody fusion and percutaneous pedicle screw fixation

VernacularTitle:斜外侧入路病灶清除植骨融合联合经皮内固定术治疗单节段腰椎结核的临床观察
Author: Chao JIANG ^{1
,

2} ; Si YIN ¹ ; Weigong ZHAO ¹ ; Yingang ZHANG ¹ ; Xiaowei ZHANG ¹ ; Yimin YANG ¹ ; Yongyuan ZHANG ^{1
,

2} ; Chaoshuai FENG ³ ; Dingjun HAO ³ ; Heng DU ¹
Author Information

1. Department of Orthopaedics, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061
2. Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, China
3. Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, China
Publication Type:Journal Article
Keywords: lumbar tuberculosis; oblique lateral interbody fusion; open surgery; debridement; percutaneous pedicle screw internal fixation
From: Journal of Xi'an Jiaotong University(Medical Sciences) 2022;43(1):69-74
CountryChina
Language:Chinese
Abstract: 【Objective】 To investigate the clinical effects of treatment of single-segment lumbar tuberculosis by oblique lateral interbody fusion with autologous iliac bone and percutaneous pedicle screw fixation. 【Methods】 We collected the clinical data of 47 patients with lumbar tuberculosis treated in The First Affiliated Hospital of Xi’an Jiaotong University from March 2017 to January 2020. Among them， 22 patients underwent oblique lateral interbody fusion with autologous iliac bone and percutaneous pedicle screw fixation （minimally invasive group） and 25 patients underwent open surgery combined anterior-debridement and posterior-fixation （control group）. The related data were collected， including gender， sex， body mass index （BMI）， systemic symptoms of tuberculosis， operation duration， intraoperative bleeding， postoperative drainage， hospital stay， complications， visual analogue score （VAS）， erythrocyte sedimentation rate （ESR）， and Oswestry disability index （ODI）. 【Results】 Baseline clinical characteristics did not significantly differ between the two groups （P>0.05）. Compared with control group， the minimally invasive group had shorter operation duration ［（188.64±18.59） min vs. （201.60±22.67） min］， less intraoperative blood loss ［（118.64±22.95） mL vs. （553.60±100.54） mL］， less postoperative drainage ［（134.55±36.48） mL vs. （291.20±61.53） mL］， and shorter hospitalization time ［（12.86±2.17） d vs. （15.80±3.03） d］（all P<0.05）. However， there was no significant difference in fusion time or complication rate （P>0.05）. Compared with the preoperative ones， ESR， VAS score and ODI score significantly decreased and Cobb angle significantly increased in both groups （all P<0.001）. At postoperative 3 months， the VAS score was lower in the minimally invasive group than in control group ［（3.59±0.96） vs. （4.16±0.85）］（P<0.05）. With regard to other characteristics， there was no significant difference between the two groups at the same point （P>0.05）. 【Conclusion】 Both minimally invasive technique and open surgery can achieve excellent clinical results， but the minimally invasive technique can reduce the surgical trauma and shorten the hospitalization time.