A comparison of three bone graft struts for interbody fusion using a posterior approach for lower lumbar spinal tuberculosis in adults: a midterm follow-up study

Abstract

Background This retrospective observational study was conducted to compare midterm outcomes of three bone graft struts for interbody fusion using a posterior approach in adults with lower lumbar spinal tuberculosis. Methods A total of 126 lower lumbar spinal tuberculosis patients were treated by one-stage posterior debridement, interbody fusion, and instrumentation. Forty-one patients (group A) were treated with autogenous bone graft for interbody fusion, 45 patients (group B) were treated with allogeneic bone grafting, and the remaining 40 (group C) patients were treated with titanium mesh cage. In addition, clinical and radiographic data were gathered and analyzed. Results At the final follow-up, all patients were completely cured. The operation period and intraoperative blood loss for groups B and C were significantly less than in group A (P = 0.000). Post-operation, neurological performance and quality of life were remarkably improved at the final follow-up. The preoperative lordosis angles of three groups were significantly improved, as evidenced by the values immediately after the operation or those at the final follow-up. The correction loss of the group C was lower than those of groups A and B (P = 0.000). All the patients obtained bone graft fusion, the fusion period of group B was longer than that of the other two groups (P = 0.000). No significant differences among the three groups in adjacent segment degeneration rates were found at the last visit (P = 0.922). Conclusions This midterm follow-up study established that one-stage posterior debridement, interbody fusion, and instrumentation, combined with medical therapy, can effectively treat lower lumbar spinal tuberculosis. In addition, the intervertebral titanium mesh cage bone graft can provide better outcomes with regard to maintaining lordosis and preventing collapse.

Comparison of clinical efficacy and surgical safety among three bone graft modalities in spinal tuberculosis: a network meta-analysis

“…Meanwhile, we discovered that TM has a unique advantage in reducing postoperative Cobb angle loss when compared with AG and AM, probably attributing to a reduction of bone resorption [ 9 ]. This result is akin to previous clinical studies demonstrating that intervertebral titanium mesh bone graft performed better in maintaining lordosis and preventing collapse than autogenous bone graft [ 14 ]. Based on these results, TM is likely to have a promising future in correcting the deformity and maintaining spinal stability.…”

Simultaneous Single-Position Oblique Lateral Interbody Fusion Combined With Unilateral Percutaneous Pedicle Screw Fixation for Single-Level Lumbar Tuberculosis: A 3-Year Retrospective Comparative Study

“…Previous studies of posterior-only approach in treating singlelevel tuberculosis had reported the average bleeding to be over 500 mL [ 26 - 29 ], consistent with our result in posterior approach. In contrast, the median blood loss in SP-OLIF group was significantly reduced (320 [450–290] mL vs. 500 [600–400] mL, p<0.05), which should be ascribed to the following aspects.…”

Recent Advances in Nanotechnology-Based Strategies for Bone Tuberculosis Management

“…The primary causative agent, Mycobacterium tuberculosis, typically leads to an infection in the spine and large joints due to their abundant blood supply. The spine is the most frequently affected skeletal site, representing the majority of skeletal TB cases [ 8 , 10 , 11 ].…”