This study aimed to determine the efficacy and safety of anterior debridement and reconstruction with anatomical screw-plate fixation in patients with lumbosacral junction tuberculosis (TB).A total of 48 patients (30 males and 18 females) diagnosed with lumbosacral junction TB were included in this study. All patients underwent surgery in our institution from January 2008 to July 2014, using anterior debridement and reconstruction with anatomical screw-plate. Outcome data were evaluated before and after surgery and included lumbosacral angle, Frankel classification, bone fusion, and visual analog scale (VAS) scores.All patients were then followed up for an average of 49.4 months (range, 24–96 months). The mean lumbosacral angle improved from 8.36° ± 5.92° pre-operation to 22.38° ± 4.52° post-operation and 21.13° ± 3.73° during the final follow-up (both P < .05). Solid vertebral fusion was achieved in all patients after 7.6 months on average (range, 6–12 months). No severe complications appeared during operation and post-operation. Neurological performance and VAS scores were significantly improved compared with pre-operation (P < .05).Following standard anti-TB chemotherapy, anterior debridement and reconstruction with anatomical screw-plate fixation may be a feasible and effective therapeutical option for lumbosacral junction TB. This procedure can result in satisfactory bone fusion and deformity correction, and effectively restore lumbosacral junction stability.
BackgroundKnowledge on periprosthetic infection and mortality rate following total knee arthroplasty (TKA) is essential for justifying this treatment in patients with cancer; however, relevant data from population-based studies are lacking. Therefore, we examined 1-year periprosthetic infection, mortality, and 5-year relative survival rates in cancer patients who underwent TKA.MethodsThis is a population-based cohort study based on analysis of the Taiwan National Health Insurance Research Database. We enrolled a total of 2294 cancer patients and 131,849 patients without cancer (control group) who underwent TKA between January 1, 1997, and December 31, 2011. All patients were followed until death, infection, withdrawal from the National Health Insurance, or December 31, 2012.ResultsThe periprosthetic knee joint infection rate in cancer patients (1.73%) was not significantly higher than that in the control group (1.87%). However, the 1-year mortality rate was significantly higher (p < 0.05) in the cancer group (4.10%) than in the control group (1.66%). The overall 5-year survival rate was 93.10% as compared with those without cancers.ConclusionLow periprosthetic knee joint infection rates and high 5-year relative survival rates indicate the feasibility of TKA in cancer patients. However, the surgeon should take into account a higher mortality rate in the first year following TKA.
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