Asian Spine J.  2017 Apr;11(2):305-313. 10.4184/asj.2017.11.2.305.

One-Stage Anterolateral Debridement, Bone Grafting, and Internal Fixation for Treating Lumbosacral Tuberculosis

• Zhang T
• Ma L
• Lan X
• Zhen P
• Wang S
• Li Z

• KMID: 2377765
• DOI: http://doi.org/10.4184/asj.2017.11.2.305

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.

Keyword

Lumbosacral tuberculosis; Tuberculous spondylitis; Anterolateral debridement; Extraperitoneal debridement; Internal fixation

MeSH Terms

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
C-Reactive Protein