Application of anterior debridement and reconstruction with anatomical screw-plate fixation for lumbosacral tuberculosis

Abstract

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.

Comparison of Anterior only and Combined Anterior and Posterior Approach in Treating Lumbosacral Tuberculosis

“…As indicated by our results, duration of operation, blood loss, and length of hospital stay of were significantly longer in the AP group compared to the ARCH group. All measured parameters in patients using the ARCH system were also superior to results obtained from other studies on the anterior approach 10,11 . Interestingly, the ARCH group achieved similar clinical outcomes to that of the AP group.…”

Anterior Transpedicle Screw in Lumbosacral Spine and Radiographic Measurements: A Retrospective Analysis

“…Limited studies, however, have reported on the details of procedures using the APS. As an effective means of pedicle screw xation, APS not only provides superior postoperative spinal stability for ALIF, but allows a shorter operating time, less blood loss, and minimal posterior muscle damage [4,5].…”

“…However, ALIF-PPS would increase the number of incision, the operating time and blood loss. While stand-alone ALIF has potential bene t of shorter operating time, less blood loss and sparing of posterior muscle damage [4,5].…”

Ineffective One-Stage Surgical Treatment of Disseminated Tuberculous Spondylitis: A Clinical Case and Literature Review

“…Современные методы хирургического лечения туберкулезного спондилита позволяют поэтапно или одномоментно устранять деструктивные процессы в позвоночнике, проводить костно-пластическое замещение дефекта тел позвонков и восстанавливать его опороспособность [21,44,57]. Однако тактика оперативного лечения, особенно в случаях распространенных форм туберкулезного спондилита, остается предметом дискуссии.…”

“…Современные методы хирургического лечения туберкулезного спондилита подробно разработаны и включают в себя разнообразные одномоментные и этапные декомпрессивно-стабилизирующие операции на позвоночнике [8,10,44,47,48,54,57,64,65], обычно выполняемые из переднебоковых или комбинированных доступов [2,6,7,17,18,22,23,32]. Предметом дискуссий остаются выбор очередности этапов операции, использование различных вариантов задней фиксации и методик санации очага и фиксации позвоночника, в том числе из задних доступов.…”