Posterior intervertebral space debridement, annular bone grafting and instrumentation for treatment of lumbosacral tuberculosis
Abstract Background The choice of surgical methods for lumbosacral tuberculosis is controversial due to the complex anterior anatomy and peculiar biomechanics of the lumbosacral junction. The objective of this study was to explore the clinical effect of posterior intervertebral space debridement wit...
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| Format: | Article |
| Language: | English |
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BMC
2017-12-01
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| Series: | BMC Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s12893-017-0310-2 |
| _version_ | 1818250560622559232 |
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| author | Weiwei Li Jun Liu Liqun Gong Yongchun Zhou Dapeng Duan |
| author_facet | Weiwei Li Jun Liu Liqun Gong Yongchun Zhou Dapeng Duan |
| author_sort | Weiwei Li |
| collection | DOAJ |
| description | Abstract Background The choice of surgical methods for lumbosacral tuberculosis is controversial due to the complex anterior anatomy and peculiar biomechanics of the lumbosacral junction. The objective of this study was to explore the clinical effect of posterior intervertebral space debridement with annular bone graft fusion and fixation for the treatment of lumbosacral tuberculosis. Methods We retrospectively analysed data from 23 patients with lumbosacral tuberculosis who had undergone posterior intervertebral space debridement with annular bone fusion and fixation between January 2008 and September 2014. The mean age of the patients was 49.0 years (range, 27–71), and the mean duration of disease until treatment was 10.2 months (range, 6–20). The lumbosacral angle, visual analogue scale (VAS) score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, American Spinal Injury Association (ASIA) grade and Social Functioning-36 (SF-36) score were determined to ascertain the clinical effects of the treatment. Results All patients underwent follow-up observation. The mean follow-up time was 34.2 months (range, 18–45), the mean operation time was 167.0 min (range, 130–210) and the mean blood loss was 767.4 ml (range, 500–1150). The lumbosacral angle was 21.0° ± 2.1° before operation, rising to 28.8° ± 1.7° after operation (p < 0.05) and being maintained thereafter. The mean VAS score before operation was 8.1 ± 0.6, decreasing to 1.2 ± 0.5 (p < 0.05) at the final follow-up. The mean ESR and CRP values were 49.1 ± 5.6 mm and 64.9 ± 11.9 mg/L, respectively, before operation, decreasing to normal at the final follow-up. The preoperative ASIA grade was C in 6 patients, D in 12 and E in 5. At the final follow-up, all patients had an ASIA grade of E except for one patient with a grade of D. For all patients, the SF-36 score at the final follow-up was higher than the preoperative and postoperative scores. Conclusions Posterior intervertebral space debridement with annular bone graft fusion and fixation is an effective treatment for lumbosacral spine tuberculosis. |
| first_indexed | 2024-12-12T15:54:20Z |
| format | Article |
| id | doaj.art-13cddc61f0654a9495f62956860cb45a |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-12T15:54:20Z |
| publishDate | 2017-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-13cddc61f0654a9495f62956860cb45a2022-12-22T00:19:31ZengBMCBMC Surgery1471-24822017-12-011711710.1186/s12893-017-0310-2Posterior intervertebral space debridement, annular bone grafting and instrumentation for treatment of lumbosacral tuberculosisWeiwei Li0Jun Liu1Liqun Gong2Yongchun Zhou3Dapeng Duan4Department of Orthopedic, Shaanxi Provincial People’s HospitalDepartment of Orthopedic, Shaanxi Provincial People’s HospitalDepartment of Orthopedic, Shaanxi Provincial People’s HospitalDepartment of Sports Medicine Research Center of Sports Medicine Xiangya Hospital, Central South UniversityDepartment of Orthopedic, Shaanxi Provincial People’s HospitalAbstract Background The choice of surgical methods for lumbosacral tuberculosis is controversial due to the complex anterior anatomy and peculiar biomechanics of the lumbosacral junction. The objective of this study was to explore the clinical effect of posterior intervertebral space debridement with annular bone graft fusion and fixation for the treatment of lumbosacral tuberculosis. Methods We retrospectively analysed data from 23 patients with lumbosacral tuberculosis who had undergone posterior intervertebral space debridement with annular bone fusion and fixation between January 2008 and September 2014. The mean age of the patients was 49.0 years (range, 27–71), and the mean duration of disease until treatment was 10.2 months (range, 6–20). The lumbosacral angle, visual analogue scale (VAS) score, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, American Spinal Injury Association (ASIA) grade and Social Functioning-36 (SF-36) score were determined to ascertain the clinical effects of the treatment. Results All patients underwent follow-up observation. The mean follow-up time was 34.2 months (range, 18–45), the mean operation time was 167.0 min (range, 130–210) and the mean blood loss was 767.4 ml (range, 500–1150). The lumbosacral angle was 21.0° ± 2.1° before operation, rising to 28.8° ± 1.7° after operation (p < 0.05) and being maintained thereafter. The mean VAS score before operation was 8.1 ± 0.6, decreasing to 1.2 ± 0.5 (p < 0.05) at the final follow-up. The mean ESR and CRP values were 49.1 ± 5.6 mm and 64.9 ± 11.9 mg/L, respectively, before operation, decreasing to normal at the final follow-up. The preoperative ASIA grade was C in 6 patients, D in 12 and E in 5. At the final follow-up, all patients had an ASIA grade of E except for one patient with a grade of D. For all patients, the SF-36 score at the final follow-up was higher than the preoperative and postoperative scores. Conclusions Posterior intervertebral space debridement with annular bone graft fusion and fixation is an effective treatment for lumbosacral spine tuberculosis.http://link.springer.com/article/10.1186/s12893-017-0310-2PosteriorIntervertebral space debridementBone graftFixationFusion |
| spellingShingle | Weiwei Li Jun Liu Liqun Gong Yongchun Zhou Dapeng Duan Posterior intervertebral space debridement, annular bone grafting and instrumentation for treatment of lumbosacral tuberculosis BMC Surgery Posterior Intervertebral space debridement Bone graft Fixation Fusion |
| title | Posterior intervertebral space debridement, annular bone grafting and instrumentation for treatment of lumbosacral tuberculosis |
| title_full | Posterior intervertebral space debridement, annular bone grafting and instrumentation for treatment of lumbosacral tuberculosis |
| title_fullStr | Posterior intervertebral space debridement, annular bone grafting and instrumentation for treatment of lumbosacral tuberculosis |
| title_full_unstemmed | Posterior intervertebral space debridement, annular bone grafting and instrumentation for treatment of lumbosacral tuberculosis |
| title_short | Posterior intervertebral space debridement, annular bone grafting and instrumentation for treatment of lumbosacral tuberculosis |
| title_sort | posterior intervertebral space debridement annular bone grafting and instrumentation for treatment of lumbosacral tuberculosis |
| topic | Posterior Intervertebral space debridement Bone graft Fixation Fusion |
| url | http://link.springer.com/article/10.1186/s12893-017-0310-2 |
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