Abstract
BackgroundThere has been no consensus regarding what is the optimal means of treating lumbosacral segment tuberculosis. The aim of this study was to evaluate the clinical outcomes of our newly developed one-stage anterior debridement and fusion combined with dual screw-rod construct anterior instrument underneath the iliac vessels for lumbosacral spinal tuberculosis.MethodsWe retrospectively reviewed 22 patients with lumbosacral spinal tuberculosis who underwent one-stage anterior debridement and fusion combined with dual screw-rod anterior instrument underneath the iliac vessels between January 2004 and June 2013. We assessed the visual analogue scale (VAS), erythrocyte sedimentation rates (ESR), neurological performance, kyphotic angles, fusion rates, and computed tomographic angiography (CTA) before and after surgery.ResultsAll patients were followed-up for a mean of 46.59 months. There were no instances of spinal tuberculosis recurrence. The mean VAS scores and ESR decreased significantly from the preoperative levels both postoperatively and at the final follow-up (all P <0.001). The mean kyphotic angle significantly increased from the mean preoperative angle both postoperatively and at the final follow-up (both P <0.001). All patients had bone fusion at a mean of five months after surgery. No postoperative vascular complications were observed.ConclusionsOur findings suggest that anterior radical debridement, fusion combined with dual screw-rod anterior instrument underneath the iliac vessels can be an effective and safe treatment option for lumbosacral segment tuberculosis.
Highlights
There has been no consensus regarding what is the optimal means of treating lumbosacral segment tuberculosis
As with other cases of spinal tuberculosis, conservative treatment is often recommended for lumbosacral spinal tuberculosis patients with signs of abscesses, cavities, sequestra, and sinus formation
Special titanium plate or screw-rod system has been available for patients with lumbosacral tuberculosis who are about to undergo the debridement and fusion due to the peculiar anatomical structures of the lumbosacral spine
Summary
There has been no consensus regarding what is the optimal means of treating lumbosacral segment tuberculosis. As with other cases of spinal tuberculosis, conservative treatment is often recommended for lumbosacral spinal tuberculosis patients with signs of abscesses, cavities, sequestra, and sinus formation. Zhang et al BMC Musculoskeletal Disorders (2016) 17:49 surgical approach for the treatment of lumbosacral segment tuberculosis. Special titanium plate or screw-rod system has been available for patients with lumbosacral tuberculosis who are about to undergo the debridement and fusion due to the peculiar anatomical structures of the lumbosacral spine. These special internal fixation constructs will undoubtedly increase the economic burden of patients in developing countries. The authors of this study attempted to achieve the one-stage debridement and fusion and reduced patient costs with conventional dual screw-rod system
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