Evaluation of the efficacy of OLIF combined posterior internal fixation for single-segment lumbar tuberculosis: a single-center retrospective cohort study

Abstract

Objective To evaluate the clinical efficacy of oblique lateral interbody fusion (OLIF) combined posterior fixation for single-segment lumbar tuberculosis (TB). Methods The medical records of spinal TB patients who were admitted to our department from January 2016 to December 2018 were retrospectively reviewed, and those meeting the inclusion criteria were finally included for analysis. The operative time, operative blood loss, hospital stay, visual analogue scale (VAS) score, Oswestry disability index (ODI), Cobb angle of surgical segment, bone graft fusion rate, erythrocytic sedimentation rate (ESR), C-reactive protein (CRP), neurological function (ASIA grade) and complications of the included patients were all recorded and analyzed. Results Thirty-nine patients with lumbar TB were finally included. The mean operative time, operative blood loss, and hospital stay were 135.8 ± 19.2 min, 239.4 ± 84.7 ml, and 9.5 ± 2.7 days, respectively. The mean follow-up time was 26.3 ± 7.5 months. During the follow-up, both VAS score and ODI were significantly improved at 1 month, 3 months, 6 months, 1 year postoperative, and the last follow-up, compared with preoperative (P < 0.001). Cobb angle was significantly corrected at 1 month postoperatively (P < 0.001), however, from 3 months postoperative to the last follow-up, Cobb angle was getting lost (P < 0.01). Bone graft fusion rate at 3 months, 6 months, 1 year postoperative, and last follow-up were 66.67%, 87.18%, 94.88%, and 100%, respectively. Compared with preoperative, ESR and CRP were both showed significant decrease at 1 and 6 months postoperative, and the last follow-up (P < 0.001). At the last follow-up, all patients had improvement in ASIA grade compared with preoperative (P < 0.001). Six patients were found with postoperative complications, and all were cured after active treatment. Conclusions OLIF combined posterior internal fixation is safe and effective in the treatment of single-segment lumbar TB, with satisfactory pain relief, improvement of lumbar and neurological function, and deformity correction.

Changes of Mycobacterium tuberculosis specific antigen-stimulated CD27 - CD38 + IFN- γ + CD4 + T cells before and after anti-tuberculosis treatment

“…The speed of ESR can help to observe the changes of the disease, including rheumatism and TB. In some studies [20,21], the expression changes of CD27 − CD38 + in IFN-γ + CD4 + cells between 2 months after treatment and baseline was positively correlated with ESR changes. In our study, the expression changes of CD27 − , CD38 + and CD27 − CD38 + were positively correlated with ESR at 6 months after treatment, and CD27 − CD38 + was the most closely correlated one.…”

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

“…Fortunately, the last decade had witnessed impressive advance of minimally invasive lateral retroperitoneal approach in treating lumbar spondylopathies, especially oblique lateral interbody fusion (OLIF) applied in management of disc degeneration diseases with the goal of minimizing intraoperative blood loss, decreasing postoperative pain, facilitating early ambulation and discharge from hospital [ 6 - 9 ]. Meanwhile, the technique had also been reported to be applied in treating tuberculous spondylitis with satisfactory results confirmed [ 10 ]. Nevertheless, classical OLIF surgery involved lateral decubitus position for debridement and reconstruction followed by prone position for posterior instrumentation to achieve rigid fixation, necessitating intraoperative reposition, inevitably prolonging operative time and triggering risk of position-oriented morbidities, which had been considered an apparent deficiency in treating lumbar tuberculosis.…”

“…[6][7][8][9] Meanwhile, the technique had also been reported to be applied in treating tuberculous spondylitis with satisfactory results confirmed. 10 Nevertheless, classical OLIF surgery involved lateral decubitus position for debridement and reconstruction followed by prone position for posterior instrumentation to achieve rigid fixation, necessitating intraoperative reposition, inevitably prolonging operative time and triggering risk of position-oriented morbidities, which had been considered an apparent deficiency in treating lumbar tuberculosis.…”

Circumferential approach via dynamic position in OLIF combined with freehand screw pedicle fixation for lumbar tuberculosis requiring multilevel instrumentation: a 3-year retrospective study

“…The last decade had witnessed profound progress of lateral extraperitoneal approach in treating degenerative diseases [ 6 ]. Meanwhile, innovative application of lateral technique had also been reported in treating lumbar tuberculosis involving single-level fixation with satisfactory clinical results confirmed [ 7 ]. Nevertheless, the minimally invasive lateral approach had rarely been recommended in treating lumbar tuberculosis concurrent with severe bony defect requiring multisegmented fixation, as long-segment percutaneous fixation required intraoperative flipping to prone position, which would inevitably lead to staged procedures and prolonged operation time, along with position-oriented morbidities including cage slipping; Meanwhile, excessive radiation exposure had been an increasing concern especially for surgeons performing the surgeries frequently [ 8 ].…”