Abstract
ObjectiveTo evaluate the clinical efficacy of oblique lateral interbody fusion (OLIF) combined posterior fixation for single-segment lumbar tuberculosis (TB).MethodsThe medical records of spinal TB patients who were admitted to our department from January 2016 to December 2018 were retrospectively reviewed, and those meeting the inclusion criteria were finally included for analysis. The operative time, operative blood loss, hospital stay, visual analogue scale (VAS) score, Oswestry disability index (ODI), Cobb angle of surgical segment, bone graft fusion rate, erythrocytic sedimentation rate (ESR), C-reactive protein (CRP), neurological function (ASIA grade) and complications of the included patients were all recorded and analyzed.ResultsThirty-nine patients with lumbar TB were finally included. The mean operative time, operative blood loss, and hospital stay were 135.8 ± 19.2 min, 239.4 ± 84.7 ml, and 9.5 ± 2.7 days, respectively. The mean follow-up time was 26.3 ± 7.5 months. During the follow-up, both VAS score and ODI were significantly improved at 1 month, 3 months, 6 months, 1 year postoperative, and the last follow-up, compared with preoperative (P < 0.001). Cobb angle was significantly corrected at 1 month postoperatively (P < 0.001), however, from 3 months postoperative to the last follow-up, Cobb angle was getting lost (P < 0.01). Bone graft fusion rate at 3 months, 6 months, 1 year postoperative, and last follow-up were 66.67%, 87.18%, 94.88%, and 100%, respectively. Compared with preoperative, ESR and CRP were both showed significant decrease at 1 and 6 months postoperative, and the last follow-up (P < 0.001). At the last follow-up, all patients had improvement in ASIA grade compared with preoperative (P < 0.001). Six patients were found with postoperative complications, and all were cured after active treatment.ConclusionsOLIF combined posterior internal fixation is safe and effective in the treatment of single-segment lumbar TB, with satisfactory pain relief, improvement of lumbar and neurological function, and deformity correction.
Highlights
Osteoarticular tuberculosis (TB) is the most common form of extrapulmonary TB, with about 50% of cases occurring in the spine [1]
We found that oblique lateral interbody fusion (OLIF) combined posterior internal fixation in the treatment of degenerative lumbar spondylolisthesis has the advantages of less surgical invasion, better decompression effect and faster postoperative recovery compared with the posterior approach surgery [11]
Postoperative visual analogue scale (VAS) score and Oswestry disability index (ODI) showed a trend of gradual decline (Fig. 2a)
Summary
Osteoarticular tuberculosis (TB) is the most common form of extrapulmonary TB, with about 50% of cases occurring in the spine [1]. Lumbar TB is the most common spine TB, often resulting in vertebral destruction, collapse, spinal instability, deformity, and even. The treatment of spinal TB mainly includes anti-TB chemotherapy and surgery. It is currently considered that anti-TB chemotherapy is the cornerstone of spinal TB treatment and surgery is mainly used for patients with severe spinal instability, spinal deformity, or impaired neurological function [3]. Application of posterior approach surgery in lumbar TB has been showed satisfactory clinical efficacy and safety, including improvement in clinical symptoms, high bone fusion rate and good deformity correction effect [5]. Cases of chronic back pain or lower limb weakness are not rarely reported after the posterior approach surgery which may be due to the stripping of unilateral or bilateral parvertebral muscles and the opening of the spinal canal during the surgical procedure [6, 7].
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