One-stage anterior debridement,bone grafting fusion and posterior single segment fixation for the treatment of lumbar spinal tuberculosis with severe vertebral bone defect
ZHANG Shu-wen
WANG Yang
Dilimulati Aikeremu
WANG Hao
Abstract：Objective To evaluate the feasibility and outcomes of the treatment for lumbar tuberculosis with severe vertebral bone defect by one-stage anterior debridement,bone grafting fusion and posterior single segment fixation.Methods The retrospective study evaluated the clinical data of 26 patients with lumbar spinal tuberculosis with vertebral bone defect admitted to the Department of Spine Surgery from June 2020 to June 2023.There were 19 males and 7 females,aged 20 to 69 years,with an average age of(39.00±15.38)years.All patients were treated with one-stage anterior debridement,bone grafting fusion and posterior single segment fixation.The demographics,disease characteristics,duration of the operation,blood loss and complications were recorded and investigated.Preoperative and postoperative visual analog scale(VAS),Oswestry disability index(ODI)and Frankel scale were compared to evaluate the symptoms and neurological function.C-reactive protein(CRP)levels,erythrocyte sedimentation rate(ESR)and imaging parameters were recorded to investigate clinical efficacy.Results The average period of follow-up was(18.42±5.23)months(range:12-33 months).The duration of the operation was(166.15±27.58)min(range:140-240 min)and the blood loss was(230.00±96.42)ml(range:90-440 ml).The VAS scores at postoperative 1 month,6 months and final follow-up were significantly lower than the preoperative data.The ODI at follow-up was improved compared with that preoperatively.At the last follow-up,neurological functions of 2 patients recovered to grade D,other patients recovered to grade E.CRP and ESR returned to normal at final follow-up in all patients.The Cobb's angles were decreased from preoperative(9.31±3.16)° to(3.23±1.39)°,and(3.42±1.53)° at final follow-up,without obvious angle loss at final follow-up.Fusion was achieved after intervertebral bone grafting at the last follow-up.During the follow-up,1 patient with recurrent lumbar tuberculosis was cured after drainage.No internal fixation failure was observed.Conclusions One-stage anterior debridement,bone grafting fusion and posterior single segment fixation are probably feasible and effective for patients with lumbar spinal tuberculosis and severe bone defect.
Keywords：TuberculosisspinalLumbar vertebraeOrthopedic procedures
Publication Date：2026-01-19
Online Publishing Date：2026-03-09(First online date of this platform, not the publication date of the document)
Pages：7( 7-13 )