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Single-stage posterior resection of the transversal process combined with an intervertebral foraminal approach for debridement, interbody fusion, internal fixation for the treatment of lumbar tuberculosis and psoas major abscess

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A Correction to this article was published on 19 January 2022

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Abstract

Purposes

To investigate the feasibility and clinical efficacy of the treatment for lumbar tuberculosis with psoas major abscess with single-stage posterior resection of the transversal process combined with an intervertebral foraminal approach for debridement, interbody fusion, internal fixation.

Methods

This retrospective study evaluated the clinical data of 24 patients (14 males and 10 females) with lumbar tuberculosis and psoas major abscess admitted to the Comprehensive Surgery from June 2016 to June 2019. All patients were treated with the single-stage posterior approach to remove the transverse process combined with the intervertebral foramina approach for debridement, interbody fusion, internal fixation. The quadruple anti-tuberculosis drug therapy was given both pre-operatively and post-operatively. Clinical symptoms and complications were investigated and recorded. The visual analogue scale (VAS), American Spinal Injury Association (ASIA), degree of lesion fusion C-reactive protein (CRP) levels, and erythrocyte sedimentation rate (ESR) were evaluated.

Results

The average follow-up period was 16. 5 months (from 12 to 36 months). The average VAS score at three months post-operation was significantly declined than the pre-operative VAS score [(2.17 ± 0.87) points vs (5.46 ± 1.22) points, t =  − 11.534, P < 0.01)]. At the last follow-up, the neurological function of 20 patients recovered to grade E, whereas four patients were still in grade D. The ESR and CRP returned to normal levels in all patients. Bone fusion was achieved in nine cases at six months, 11 cases at nine months, and four cases at 12 months. The incisions of 23 patients had healed nicely without chronic sinus. Poor incision healing only happened in one case at the day 12 post-operation. The bone grafts among the lesions obtained bony fusion. Besides, there was no recurrence of tuberculosis, loosening or fracture of internal fixation during the follow-up.

Conclusion

Single-stage posterior resection of the transversal process combined with an intervertebral foramina approach for debridement, interbody fusion, internal fixation is probably an effective and safe approach of the treatment for lumbar tuberculosis combined with psoas major abscess, producing few complications. This technique provides an alternative method for the surgical treatment of lumbar tuberculosis combined with psoas major abscess.

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Data availability

All data are available from the corresponding author.

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Authors and Affiliations

  1. Comprehensive Surgery (Special Surgery), First Affiliated Hospital of Xinjiang Medical University, No. 137 South Liyushan Road, Urumqi, China

    Zhongwei Li & Gele Jin

  2. College of Nursing, Xinjiang Medical University, Urumqi, China

    Miao He

  3. Medical Cosmetic Center, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China

    Xi Chen

  4. Department of Spine Surgery, General Hospital of Xinjiang Military Region, Urumqi, China

    Xinming Yang

  5. Department of Spine Surgery II, Xinjiang Provincial People Hospital, No. 91 Tianchi Road, Urumqi, 830000, China

    Shuwen Zhang

Authors
  1. Zhongwei Li
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  2. Miao He
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  3. Xi Chen
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  4. Xinming Yang
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  5. Shuwen Zhang
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  6. Gele Jin
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Contributions

hongwei Li and Shuwen Zhang conceived the project. Zhongwei Li and Miao He wrote the manuscript. Xinming Yang, Xi Chen, and Jingele offered technical support. Zhongwei Li and Shuwen Zhang participated in revising the manuscript. All authors approved the manuscript.

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Correspondence to Zhongwei Li or Shuwen Zhang.

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I would like to declare on behalf of my co-authors that the work described was original research that has not been published previously, and not under consideration for publication elsewhere, in whole or in part. All the authors listed have approved the manuscript that is enclosed.

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The authors declare no competing interests.

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The original version of this article was revised. The correct copyright should be “The Author(s) under exclusive licence to SICOT aisbl.”

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Li, Z., He, M., Chen, X. et al. Single-stage posterior resection of the transversal process combined with an intervertebral foraminal approach for debridement, interbody fusion, internal fixation for the treatment of lumbar tuberculosis and psoas major abscess. International Orthopaedics (SICOT) 46, 331–339 (2022). https://doi.org/10.1007/s00264-021-05244-6

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  • DOI: https://doi.org/10.1007/s00264-021-05244-6

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