Abstract
BackgroundTo compare the clinical and radiological outcomes between posterior mono-segment and short-segment fixation combined with one-stage posterior debridement and bone grafting fusion in treating single-segment lumbar spinal tuberculosis (LSTB).MethodsSixty-two patients with single-segment LSTB treated by a posterior-only approach were divided into two groups: short-segment fixation (Group A, n = 32) and mono-segment fixation (Group B, n = 30). The clinical and radiographic outcomes were analyzed and compared between the two groups.ResultsThe intraoperative bleeding volume, operation time, and hospitalization duration were lower in Group B than in Group A. All patients achieved the bony fusion criteria. The visual analog scale score, Japanese Orthopedic Association score, and Oswestry Disability Index were substantially improved 3 months postoperatively and at the last visit in both groups, with no significant difference between the two groups (P > 0.05). Kirkaldy–Willis functional evaluation at the final follow-up demonstrated that all patients in both groups achieved excellent or good results. The difference in the angle correction rate and correction loss between Groups A and B was not significant (P > 0.05).ConclusionsOne-stage posterior debridement, bone grafting fusion, and mono-segment or short-segment fixation can provide satisfactory clinical and radiological outcomes. Mono-segment fixation is more suitable for the treatment of single-segment LSTB because the lumbar segments with normal motion can be preserved with less trauma, a shorter operation time, shorter hospitalization, and lower costs.
Highlights
To compare the clinical and radiological outcomes between posterior mono-segment and shortsegment fixation combined with one-stage posterior debridement and bone grafting fusion in treating singlesegment lumbar spinal tuberculosis (LSTB)
In our previous study [2], we found that in treating thoracolumbar junction Spinal TB (STB), long-segment internal fixation with a posterior-only approach prevailed over short-segment fixation in terms of kyphotic correction and maintenance of spinal stability, especially in the long-term prevention of angle loss
The inclusion criteria were as follows: the main lesion involved a functional unit of the lumbar spine (L2–S1), mono-segment or short-segment fixation was performed by a posterior-only approach, pathological examination revealed a definitive diagnosis of TB, and the patient underwent a minimum 5-year follow-up
Summary
To compare the clinical and radiological outcomes between posterior mono-segment and shortsegment fixation combined with one-stage posterior debridement and bone grafting fusion in treating singlesegment lumbar spinal tuberculosis (LSTB). Spinal TB (STB) is the most frequent and serious form of skeletal TB and can cause vertebral collapse, spinal deformity, neurological injury, and even paraplegia [2, 3]. Conservative treatment with anti-TB chemotherapy is the mainstay of STB therapy [4] and can yield good to excellent clinical outcomes in most patients; it cannot prevent kyphotic aggravation. Medical therapy is the fundamental means of curing musculoskeletal TB, and surgery is an adjunct to anti-TB chemotherapy. Surgery is performed to debride the lesion and to decompress the spinal cord, restore normal spinal alignment, and reconstruct the spinal stability
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
