Abstract
BackgroundTo investigate the clinical efficacy of minimally invasive direct lateral approach debridement, interbody bone grafting, and interbody fusion in the treatment of the thoracic and lumbar spinal tuberculosis.MethodsFrom January 2013 to January 2016, 35 cases with thoracic and lumbar spinal tuberculosis received direct lateral approach debridement, interbody bone grafting, and interbody fusion. Of the 35 cases, 16 patients were male and 19 were female and the median age was 55.2 (range 25–83). The affected segments were single interspace, and the involved vertebral bodies included: 15 cases of thoracic vertebrae (1 cases of T5/6, 2 cases of T6/7, 4 cases of T7/8, 3 cases of T8/9, 5 cases of T9/10) and 20 cases of lumbar spine (2 cases of L1/2, 6 cases of L2/3, 6 cases of L3/4, 6 cases of L4/5). After MIDLIF operation, all the patients received medication of four anti-tubercular drugs for 12 to18 months.ResultsThe patients were followed up for 7 to 40 months with an average of 18.5 months. The visual analogue scale (VAS) at the last follow-up was 2.8 ± 0.5, which was significantly different from the preoperative VAS (8.2 ± 0.7). After MIDLIF, there was 5 cases occurred with transient numbness in one side of the thigh or inguinal region, and 10 cases suffered from flexion hip weakness. All the bone grafts were fused within 6~ 18 months (average of 11.5 months) after the operation.ConclusionMinimally invasive lateral approach interbody fusion technology have the advantage of less injury and quick recovery after surgery, which is the effective and safe treatment for thoracic and lumbar spinal tuberculosis.
Highlights
To investigate the clinical efficacy of minimally invasive direct lateral approach debridement, interbody bone grafting, and interbody fusion in the treatment of the thoracic and lumbar spinal tuberculosis
The conventional digital X - line (DR), computed tomography (CT) and magnetic resonance imaging (MRI) examinations were performed before the operation, and combination of the results of erythrocyte sedimentation rate (ESR) to produce a diagnosis as spinal tuberculosis
18 months and 24 months, the patient received DR and CT again, respectively, and the results indicated the good bone fusion and good position of internal fixation (Fig. 3)
Summary
To investigate the clinical efficacy of minimally invasive direct lateral approach debridement, interbody bone grafting, and interbody fusion in the treatment of the thoracic and lumbar spinal tuberculosis. With the change of living environment, the epidemic situation of tuberculosis (TB) is still grim. China ranks second next to India among 22 high-burden countries despite decades’ effort on TB control [1]. The complications of Spinal tuberculosis including instability of the spine, spinal deformity and spinal cord compression, and even paralysis. Surgical therapy is recommended and required after the above complications occur [2]. Traditional surgical treatment has the features of large trauma and slow postoperative
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