One-stage posterior debridement, interbody fusion, and instrumentation for lumbosacral junction tuberculosis in adults
XU Zhen-chao
CHEN Gang
ZENG Kai-bin
ZHANG Zhi-guo
YU Hai-liang
HAN Ying-song
Abstract：Objective To investigate the feasibility and the clinical efficacy of one-stage posterior debridement, interbody fusion, and instrumentation for lumbosacral junction tuberculosis in adults. Methods A retrospective study of 16 cases (L5, S1; lumbosacral junction tuberculosis accompanied by paravertebral or spinal canal abscess) in our department, from July 2008 to July 2013, was conducted. There were 9 males and 7 females, with the mean age of (46.7 ± 12.5) years (range: 23 - 66 years). The mean lumbosacral angle of segmental spinal lesions preoperation was (21.9 ± 1.9) ° (range: 18° - 24°). American Spinal Injury Association (ASIA): grade C in 5 cases, grade D in 8 cases, and grade E in 3 cases. All the patients were treated with one-stage posterior debridement, interbody fusion, and instrumentation. Postoperative complications, Visual Analogue Scale (VAS) pain score, the ASIA, the lumbosacral angle of segmental spinal lesions and fusion time of the grafted bone were evaluated respectively to assess the feasibility and clinical efficacy. Results All patients were followed for 32 - 60 months post-operation (mean: 45.1 ±8.0 months). No severe complications occurred. The lumbosacral angle was (24° - 30°) (mean: 28.1° ± 1.7°) after surgery, and (24° - 29°) (mean: 27.1° ± 1.6°) at the final follow-up. Both were significantly increased (P ＜ 0.05). At the final follow-up visit, neurological status of the patients with preoperative neurological deficit according to the ASIA: 1 cases of grade C recovered to grade D; 4 cases of grade C recovered to grade E; 8 cases of grade D recovered to grade E. VAS was significantly improved at the end of the follow-up (P ＜ 0.05). Bone fusion occurred in all patients 9 - 15 months (mean: 11.6 ± 2.2 months) after surgery. No fixation loosening, breakage, or pseudoarticulation formation was observed. Conclusions One-stage posterior debridement, interbody fusion, and instrumentation are effective and feasible in the treatment of lumbosacral junction tuberculosis in adults with fewer complications and better quality of life.
Keywords：TuberculosisspinalLumbosacral regionSpinal fusion
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 313-318 )