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One-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation in treating lumbosacral spinal tuberculosis

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Retrospective analysis of the clinical study efficacy and feasibility of one-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation in treating lumbosacral spinal tuberculosis.

Method

A total of 21 patients with lumbosacral tuberculosis (TB) collected from January 2004 to January 2010, underwent one-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation. In addition, the clinical efficacy was evaluated based on the data on the lumbo-sacral angle, neuro-logical status that was recorded by American Spinal Injury Association (ASIA) Impairment Scale, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP), which were collected at specific time points.

Results

All cases were followed up for 16–36 months (average 24.9 ± 6.44 months). 18 patients suffered from evident neurological deficits preoperatively, of which 16 patients returned to normal at the final follow-up. Two patients with neurological dysfunction aggravated postoperative, experienced significant partial neurological recovery. With an effective and standard anti-TB chemotherapy treated, the values of ESR and CRP returned to normal levels 3-month later postoperative and maintained till the final follow-up. Preoperative lumbosacral angle was 20.89 ± 2.32° and returned 29.62 ± 1.41° postoperative. During long-term follow-up, there was only 1–3° lumbosacral angle loss. There was a significant difference between preoperative and postoperative lumbosacral angles.

Conclusion

With effective and standard anti-TB chemotherapy, one-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation for lumbosacral tuberculosis can effectively relieve pain symptoms, improve neurological function, and reconstruct the spinal stability.

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Acknowledgments

This publication was funded in part by the National Natural Science Foundation of China (81171736).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Spine Surgery, The Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan, 410008, People’s Republic of China

    Xiaoyang Pang, Ping Wu, Dongzhe Li, Chenke Luo & Xiyang Wang

  2. Department of Spine Surgery, The Hunan Provincial People’s Hospital, 61# Jiefang West Road, Changsha, Hunan, 410002, People’s Republic of China

    Xiongjie Shen

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  1. Xiaoyang Pang
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Correspondence to Xiyang Wang.

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Pang, X., Wu, P., Shen, X. et al. One-stage posterior transforaminal lumbar debridement, 360° interbody fusion, and posterior instrumentation in treating lumbosacral spinal tuberculosis. Arch Orthop Trauma Surg 133, 1033–1039 (2013). https://doi.org/10.1007/s00402-013-1751-4

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