Clinical Analysis of One-Stage Debridement,Bone Grafting and Internal Fixation for the Treatment of Single-Segmental Lumbar Spinal Tuberculosis with Extreme Lateral Approach
- VernacularTitle:极外侧入路一期病灶清除植骨内固定治疗单节段腰椎结核的疗效分析
- Author:
Jian-Wen LI
1
;
Song-Bo LI
;
Xian-Yin LIU
;
Guan-Jun FANG
;
Yao-Xin CHEN
;
Jian-Feng LU
;
Guo-Biao YE
;
Zhi-Wei LIU
Author Information
1. 东莞市人民医院//南方医科大学附属东莞人民医院骨科
- Keywords:
extreme lateral approach;
debridement;
internal fixation;
lumbar spinal tuberculosis
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2018;39(2):315-320
- CountryChina
- Language:Chinese
-
Abstract:
[Objective]To analyze the feasibility and clinical efficacy of one-stage debridement,bone grafting and in-ternal fixation for the treatment of single-segmental lumbar spinal tuberculosis with extreme lateral approach.[Methods]Thirteen patients of single-segmental lumbar spinal tuberculosis that received the surgeries from April 2013 to August 2016 were included.The operation duration and the amount of intraoperative blood loss were recorded.The VAS and ODI of the back pain,lumbar kyphosis angle,segment height restoration,and vertebral fusion rate were used to analyze the clinical efficacy.[Results]Thirteen patients were successfully followed up for 13-32 months(mean,20.3 months);the operation duration was 160-280 min(average,214±96)min;the amount of intraoperative blood loss was 150-350 mL, average(average,263±63)mL. At the final follow-up,ESR and CRP were normal and lower back pain(VAS)and Oswestry disability index(ODI)were significantly reduced(7.2±1.6 vs 2.5±1.2 and 63.3±5.4 vs 31.9±3.7,respectively)compared to preoperative values;there were no significant difference in the lumbar kyphosis angle,segment height resto-ration between preoperation(segmental lordosis,7.1°±4.7°;segmental height,64.8 mm±9.3 mm)and the values at final follow-ups(segmental lordosis,5.2°±3.5°;segmental height,69.4 mm±10.5 mm;P>0.05). All cases acquired good lumbar interbody fusion with no internal fixation failure or recurrence of tuberculosis.[Conclusions]Under systemic and routine antituberculosis chemotherapy,one-stage extreme lateral approach debridement,bone graft and internal fixation is effective and feasible for single-segmental lumbar spinal tuberculosis.
