The Posterior Instrumentation Using Compressive Laminar Hooks Combined with Anterior Interbody Fusion for the Treatment of Tuberculous Spondylitis in the Lower Lumbar Spine

Kim, Dong Jun; Wang, Jin Man

Abstract

STUDY DESIGN: The authors employed a new mode of treatment for the tuberculosis of the lower lumbar spine that has difficulty in using pedicle screws. SUMMARY OF LITERATURE REVIEW: It has been reported that patients ended up with a kyphosis had a higher incidence of back pain.
OBJECTIVES
The purpose of this study is to evaluate the efficacy of the method consisting of posterior instrumentation with compressive laminar hooks and anterior lumbar interbody fusion.
MATERIALS AND METHODS
Twenty-one patients with tuberculosis of lower lumbar spine underwent posterior instrumentation with laminar hooks and anterior interbody fusion by a single surgeon. The clinical outcomes were evaluated and the radiographs were analyzed with respect to fusion status and sagittal angle.
RESULTS
A solid bony fusion was obtained in all patients. The preoperative, immediate postoperative, and follow-up sagittal angles were -4.8 degree(range; from 2 degreeto -10 degree, SD = +/-4.1 degree), -14 degree(range; from -10 degreeto -18 degree, SD = +/-3.3 degree), and -11.3 degree(range; from -6 degree to -15 degree, SD = +/-4.1 degree), respectively. There is no complication related to the instrument, but one patient suffered a tear of inferior vena cava during the operation.
CONCLUSIONS
This method appears to be effective in stabilizing the vertebrae without sacrificing additional motion segment. We would recommend this method for tuberculosis of lower lumbar spine.