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Single-stage posterior debridement and transforaminal lumbar interbody fusion with autogenous bone grafting and posterior instrumentation in the surgical management of lumbar tuberculosis

  • Orthopaedic Surgery
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Abstract

Aim

To describe a case series to highlight the clinical effectiveness of single-stage posterior debridement and transforaminal lumbar interbody fusion (TLIF) with autogenous bone grafting and posterior instrumentation in the surgical management of lumbar tuberculosis.

Methods

This case series involves 14 lumbar tuberculosis patients treated with the above given surgical procedure. The following parameters have been evaluated: visual analog scale (VAS) score, erythrocyte sedimentation rate (ESR) and C-reactive protein value, vertebral body loss, deformity angle, kyphotic angle, lumbar lordotic angle and fusion status of affected segment. The mean time of follow-up is 38.2 months (30–46).

Results

Significant improvement was found in all radiologic parameters, and significant decrease in VAS and ESR were noted after surgery. Bony fusion was seen in all cases within a mean time of 4.3 months (range 3–7 months). No postoperative instrumental complication and recurrence were noted.

Conclusion

Single-stage posterior debridement and TLIF with autogenous bone grafting and posterior instrumentation is a safe and effective approach to treating with early-diagnosed and less-involved lumbar tuberculosis.

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References

  1. Bjune G, Cotton M, Sony AE et al (2006) Guidance for national tuberculosis programmes on the management of tuberculosis in children. World Health Organization, pp 8–9. http://whqlibdoc.who.int/hq/2006/WHO_HTM_TB_2006.371_eng.pdf. Accessed 2 Feb 2007

  2. Broner FA, Garland DE, Zigler JE (1996) Spinal infection in the immunocompromised host. Orthop Clin North Am 27:37–46

    CAS  PubMed  Google Scholar 

  3. Garst RJ (1992) Tuberculosis of the spine: a review of 236 operated cases in an undeveloped region from 1954–1964. J Spinal Disord 3:286–299

    Article  Google Scholar 

  4. Guven O, Kumano K, Talcin S et al (1994) A single stage posterior approach and rigid fixation for preventing kyphosis in the treatment of spinal tuberculosis. Spine 19:1039–1043

    Article  CAS  PubMed  Google Scholar 

  5. Kim NH, Lee HM, Suh JS (1994) Magnetic resonance imaging for the diagnosis of tuberculous spondylitis. Spine 19:2451–2455

    Article  CAS  PubMed  Google Scholar 

  6. Lee CK, Vessa P, Lee JK (1995) Chronic disabling low back pain syndrome caused by internal disc derangements: the results of disc excision and posterior lumbar interbody fusion. Spine 20:356–361

    Article  CAS  PubMed  Google Scholar 

  7. Lee JS, Moon KP, Kim SJ et al (2007) Posterior lumbar interbody fusion and posterior instrumentation in the surgical management of lumbar tuberculous spondylitis. J Bone Joint Surg Br 89B:210–214

    Google Scholar 

  8. Lee SH, Sung JK, Park YM (2006) Single-stage transpedicular decompression and posterior instrumentation in treatment of thoracic and thoracolumbar spinal tuberculosis: a retrospective case series. J Spinal Disord Tech 19:595–602

    Article  PubMed  Google Scholar 

  9. Lehmer S, Steffee A, Gaines R (1994) Treatment of L5–S1 spondyloptosis by staged L5 resection with reduction and fusion of L4 onto S1. Spine 19:1916–1925

    Article  CAS  PubMed  Google Scholar 

  10. Mehta JS, Bhojraj SY (2001) Tuberculosis of the thoracic spine: a classification based on the selection of surgical strategies. J Bone Joint Surg Br 83:859–863

    Article  CAS  PubMed  Google Scholar 

  11. Moon MS (1991) Combined posterior instrumentation and anterior interbody fusion of the thoraco-lumbar spine. Curr Orthop 5:177–179

    Article  Google Scholar 

  12. Moon MS (1997) Spine update. Tuberculosis of spine: controversies and a new challenges. Spine 22:1791–1797

    Article  CAS  PubMed  Google Scholar 

  13. Moon MS, Moon YW, Moon JL et al (2002) Conservative treatment of tuberculosis of the lumbar and lower lumbar spine. Clin Orthop 398:40–49

    Article  PubMed  Google Scholar 

  14. Moon MS (2006) Development in the management of tuberculosis of the spine. Curr Orthop 20:132–140

    Article  Google Scholar 

  15. Moon MS (2007) Tuberculosis of spine: contemporary thoughts on current issues and perspective views. Curr Orthop 27:364–379

    Article  Google Scholar 

  16. Nussbaum ES, Rockswold GL, Bergman TA et al (1995) Spinal tuberculosis: a diagnostic and management challenge. J Neurosurg 83:243–247

    Article  CAS  PubMed  Google Scholar 

  17. Rajasekaran S, Shanmugasundaram TK (1987) Prediction of the angle of gibbus deformity in tuberculosis of the spine. J Bone Joint Surg Am 69:503–509

    CAS  PubMed  Google Scholar 

  18. Rajasekaran S, Soundarapandian S (1989) Progression of kyphosis in tuberculosis of the spine treated by anterior arthrodesis. J Bone Joint Surg Am 71A:1314–1323

    Google Scholar 

  19. Yilmaz C, Selek HY, Gurkan I, Erdemli B, Korkusuz Z (1999) Anterior instrumentation for the treatment of spinal tuberculosis. J Bone Joint Surg Am 81:1261–1267

    CAS  PubMed  Google Scholar 

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Correspondence to Zhuojing Luo.

Additional information

K. Gong and Z. Wang contributed equally to this work and should be considered as co-first authors.

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Gong, K., Wang, Z. & Luo, Z. Single-stage posterior debridement and transforaminal lumbar interbody fusion with autogenous bone grafting and posterior instrumentation in the surgical management of lumbar tuberculosis. Arch Orthop Trauma Surg 131, 217–223 (2011). https://doi.org/10.1007/s00402-010-1138-8

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  • DOI: https://doi.org/10.1007/s00402-010-1138-8

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