Abstract
ObjectTo evaluate the clinical efficacy and feasibility of single-stage posterior debridement, interbody fusion and posterior instrumentation for the treatment of lumbar tuberculosis in the aged and to discuss the surgical strategies of this intervention.MethodsFrom January 2006 to January 2012, 28 elderly patients who suffered from lumbar tuberculosis underwent one-stage posterior debridement, interbody fusion and posterior instrumentation. Radiographic data which included correction of local kyphosis, loss of correction and bone fusion were carefully collected pre and postoperatively to evaluate the efficacy of surgery. Perioperative and postoperative complications were also registered. All patients were asked to fill out Oswestry Disability Index questionnaire before the surgery and at the last follow-up.ResultsAll patients (12M/16F) were followed for at least 24 months. The average kyphotic angle decreased to 11.3° ± 7.0° postoperatively from 26.4° ± 5.7° preoperatively. Meanwhile, average loss of 2.0° ± 1.5° was observed at last visit. Bone fusion occurred at 4–6 months. Neither mortalities nor any neurological complications were found in the series. 16 cases who suffered neurologic insults before surgery, the majority of patients recovered after surgery. The mean Oswestry Disability Index was significantly improved from 28.6 ± 4.9 before surgery to 10.4 ± 3.8 at last visit.ConclusionsThe outcomes of follow-up showed that single-stage posterior debridement, interbody fusion and instrumentation is an effective method for the treatment of lumbar tuberculosis in the aged.
Highlights
Spinal tuberculosis (STB) is one of the oldest diseases known to mankind and has been found in Egyptian mummies dating back to 3400 BC (Taylor et al 2007)
The study protocol was approved by Second Xiangya Hospital Ethics Committee. 28 aged patients averaged 72.3 ± 8.6 years old, with lumbar tuberculosis who had been treated in our hospital from September 2006 to September 2011 were enrolled in this study
Plain radiology, computed tomography and MRI of the spine were performed on all patients admitted with suspected spinal tuberculosis
Summary
Spinal tuberculosis (STB) is one of the oldest diseases known to mankind and has been found in Egyptian mummies dating back to 3400 BC (Taylor et al 2007). The disease is well known as Pott’s spine It is a frequently encountered extra-pulmonary form of the disease. It accounts for approximately half of all cases of musculoskeletal TB (Turgut 2001). It is characterized by formation of cold abscess, destruction of the intervertebral. China is one of the world’s two TB high burden countries, and ranked second in the incidence of TB (Wells et al 2010). It has been an important public health issue, accompanying with serious medical, social and financial impacts. With an increase in STB incidence and the rising proportion of aging population in China, STB in elderly patients is on the uptrend (Vetillard et al 2012)
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