One-Stage Anterolateral Debridement, Bone Grafting, and Internal Fixation for Treating Lumbosacral Tuberculosis.
10.4184/asj.2017.11.2.305
- Author:
Tao ZHANG
1
;
Lihua MA
;
Xu LAN
;
Ping ZHEN
;
Shiyong WANG
;
Zhilin LI
Author Information
1. Department of Spine Surgery, Lanzhou General Hospital, Lanzhou Command of Chinese PLA, Lanzhou, China. 444124272@qq.com
- Publication Type:Original Article
- Keywords:
Lumbosacral tuberculosis;
Tuberculous spondylitis;
Anterolateral debridement;
Extraperitoneal debridement;
Internal fixation
- MeSH:
Blood Sedimentation;
Bone Transplantation*;
C-Reactive Protein;
Consensus;
Debridement*;
Follow-Up Studies;
Humans;
Magnetic Resonance Imaging;
Radiography;
Recurrence;
Retrospective Studies;
Treatment Outcome;
Tuberculosis*;
Visual Analog Scale;
Wounds and Injuries
- From:Asian Spine Journal
2017;11(2):305-313
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: Retrospective case series. PURPOSE: To investigate the clinical efficacy and feasibility of one-stage anterolateral debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis. OVERVIEW OF LITERATURE: There has been no consensus regarding the optimal means of treating lumbosacral tuberculosis. The one-stage anterolateral extraperitoneal approach for radical debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis is rare in literature. METHODS: Twenty-one patients with lumbosacral tuberculosis were retrospectively analyzed. All patients underwent the surgery of anterolateral debridement after regularly antituberculous drugs therapy. We evaluated the erythrocyte sedimentation rate, C-reactive protein, radiography, computed tomography, magnetic resonance imaging, visual analogue score, and Oswestry disability index before and after surgery. RESULTS: All patients completed a follow-up survey 9–48 months after surgery. All patients' wounds healed well without chronic infection or sinus formation, and all patients with low-back pain reported relief after surgery. All cases had no tuberculosis recurrence. Solid bony fusion was achieved within 6–12 months. At final follow-up, evaluated the erythrocyte sedimentation rate decreased from 38.1±12.5 to 11.3±7.1 mm/hr, C-reactive protein decreased from 6.2±4.2 to 1.6±1.3 mg/dL, the visual analog scale score decreased from 4.6±1.1 to 1.4±1.0, the Oswestry disability index score decreased from 50.2%±11.9% to 13.0%±6.6%, and the lumbosacral angle increased from 20.0°±4.8° to 29.0°±3.9° (p<0.05). CONCLUSIONS: One-stage anterolateral debridement, bone grafting, and internal instrument fixation for treating lumbosacral tuberculosis is safe and effective.
