Neurospine.  2023 Dec;20(4):1306-1318. 10.14245/ns.2346692.346.

Simultaneous Single-Position Oblique Lateral Interbody Fusion Combined With Unilateral Percutaneous Pedicle Screw Fixation for Single-Level Lumbar Tuberculosis: A 3-Year Retrospective Comparative Study

• He J
• Deng J
• Yang Y
• Zheng T
• Luo F
• Xu J
• Zhang Z

• KMID: 2549854
• DOI: http://doi.org/10.14245/ns.2346692.346

Abstract

Objective
To illustrate a simultaneous single-position oblique lateral interbody fusion (SPOLIF) combined with unilateral percutaneous pedicle screw fixation in treating single-level lumbar tuberculosis, compared with posterior-only approach in clinical and radiographic evaluations.
Methods
Consecutive patients who had undergone surgeries for single-level lumbar tuberculosis from January 2018 to December 2020 were retrospectively reviewed. The patients included were divided into SP-OLIF and posterior-only groups according to surgical methods applied, with follow-up for at least 36 months. Outcomes included estimated blood loss, operative time, and complications for safety evaluation; visual analogue scale (VAS), Oswestry Disability Index (ODI) for efficacy evaluation; erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) for evaluating tuberculosis activity; x-ray and computed tomography scan were used for radiographic evaluation.
Results
A total of 136 patients had been enrolled in the study (60 for SP-OLIF and 76 for Posterior-only). The median operative time, blood loss, and hospital stay in SP-OLIF group were significantly less, with a lower complication rate. Meanwhile, the SP-OLIF group showed substantially lower VAS in 1 and 7 days and decreased ODI in the first month postoperatively, without significant difference afterward. Similarly, the median CRP and ESR in SP-OLIF group were significantly lower in 3 and 7 days postoperatively. All indicators had reduced to normal after 3 months. No recurrence had been reported throughout the whole follow-up.
Conclusion
SP-OLIF was an efficient minimally invasive protocol for single-level lumbar tuberculosis, facilitating earlier clinical improvement, with decreased blood loss, operative time and hospital stay compared with posterior-only approach.

Keyword

Spinal tuberculosis; Debridement; Oblique lateral interbody fusion; Single position