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One-stage extreme lateral interbody fusion and percutaneous pedicle screw fixation in lumbar spine tuberculosis

View Article: PubMed Central - PubMed

ABSTRACT

Objectives:: We explored the efficacy of minimal invasive surgery including one-stage debridement and intervertebral fusion through extreme lateral channel (XLIF) combined with lateral or percutaneous posterior pedicle screw fixation for the treatment of lumbar spine tuberculosis.

Methods:: Twenty two patients with lumbar tuberculosis who underwent surgery with XLIF technique and internal fixation were included in the study. Their data about operative time, intraoperative blood loss, bone fusion, kyphosis correction, and clinical recovery were retrospectively collected and analyzed.

Results:: The mean intraoperative blood loss was 249.8±27.8 ml and the operative time 347.5±20.7 min. At the final follow-up, 11 to 15 months postoperatively, ESR and CRP were normal and pain (VAS) and Oswestry disability index (ODI) were significantly reduced (23.0±-3.1 vs 0.6±-0.7 and 57.2±-1.6 vs 6.4±-1.2 respectively) compared to preoperative values. Progression of the kyphotic deformity was effectively prevented (mean Cobb angle 23.9° +/-1.9° vs 24.5° +/-1.4°, P>0.05). There was one failure of the fixation associated to poor therapy adherence. All the patients showed neurological recovery.

Conclusion:: Debridement and interbody fusion by extreme lateral channel combined with lateral or percutaneous posterior pedicle screw fixation effectively retained the spine stability and provided clinical and neurologic recovery in selected patients with lumbar spine tuberculosis.

No MeSH data available.


Related in: MedlinePlus

A) A 60 year old woman with spinal tuberculosis in L3-L4 B) A 79 year old female patient presented with low back pain due to destructive spinal tuberculosis at L4-L5 with a mild paravertebral abscess. C) A 36 year old male diagnosed with L2-L3 spinal tuberculosis. A titanium (A) (OR: Autologous bone grafting (B), Cage (C)) were instrumented anteriorly, and correction of kyphosis deformity was obtained after posterior percutaneous pedicle screws fixation (A, B) (OR: Lateral pedicle screws fixation (C)). Preoperative a1, a2 X-ray radiographs (Anterior and Lateral position) and b1, b2 sagittal MRI or CT, and c1, c2 postoperative X-ray radiographs and d1, d2 one year follow up X-ray radiographs.
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Figure 1: A) A 60 year old woman with spinal tuberculosis in L3-L4 B) A 79 year old female patient presented with low back pain due to destructive spinal tuberculosis at L4-L5 with a mild paravertebral abscess. C) A 36 year old male diagnosed with L2-L3 spinal tuberculosis. A titanium (A) (OR: Autologous bone grafting (B), Cage (C)) were instrumented anteriorly, and correction of kyphosis deformity was obtained after posterior percutaneous pedicle screws fixation (A, B) (OR: Lateral pedicle screws fixation (C)). Preoperative a1, a2 X-ray radiographs (Anterior and Lateral position) and b1, b2 sagittal MRI or CT, and c1, c2 postoperative X-ray radiographs and d1, d2 one year follow up X-ray radiographs.

Mentions: Postoperatively, bone interbody fusion obtained by different types of graft/implants was generally good (Figure 1). The internal fixation loosened in one case after the operation which was attributed to drug treatment disobedience and earlier frequent activities. The postoperative spinal deformity correction effect achieved good results through the imaging analysis (p>0.05) (Table 3). No case except the one mentioned before had lost the correction at the last follow-up. This patient was treated by evacuation of the psoas abscess and improvement of the adherence to drug therapy.


One-stage extreme lateral interbody fusion and percutaneous pedicle screw fixation in lumbar spine tuberculosis
A) A 60 year old woman with spinal tuberculosis in L3-L4 B) A 79 year old female patient presented with low back pain due to destructive spinal tuberculosis at L4-L5 with a mild paravertebral abscess. C) A 36 year old male diagnosed with L2-L3 spinal tuberculosis. A titanium (A) (OR: Autologous bone grafting (B), Cage (C)) were instrumented anteriorly, and correction of kyphosis deformity was obtained after posterior percutaneous pedicle screws fixation (A, B) (OR: Lateral pedicle screws fixation (C)). Preoperative a1, a2 X-ray radiographs (Anterior and Lateral position) and b1, b2 sagittal MRI or CT, and c1, c2 postoperative X-ray radiographs and d1, d2 one year follow up X-ray radiographs.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383773&req=5

Figure 1: A) A 60 year old woman with spinal tuberculosis in L3-L4 B) A 79 year old female patient presented with low back pain due to destructive spinal tuberculosis at L4-L5 with a mild paravertebral abscess. C) A 36 year old male diagnosed with L2-L3 spinal tuberculosis. A titanium (A) (OR: Autologous bone grafting (B), Cage (C)) were instrumented anteriorly, and correction of kyphosis deformity was obtained after posterior percutaneous pedicle screws fixation (A, B) (OR: Lateral pedicle screws fixation (C)). Preoperative a1, a2 X-ray radiographs (Anterior and Lateral position) and b1, b2 sagittal MRI or CT, and c1, c2 postoperative X-ray radiographs and d1, d2 one year follow up X-ray radiographs.
Mentions: Postoperatively, bone interbody fusion obtained by different types of graft/implants was generally good (Figure 1). The internal fixation loosened in one case after the operation which was attributed to drug treatment disobedience and earlier frequent activities. The postoperative spinal deformity correction effect achieved good results through the imaging analysis (p>0.05) (Table 3). No case except the one mentioned before had lost the correction at the last follow-up. This patient was treated by evacuation of the psoas abscess and improvement of the adherence to drug therapy.

View Article: PubMed Central - PubMed

ABSTRACT

Objectives:: We explored the efficacy of minimal invasive surgery including one-stage debridement and intervertebral fusion through extreme lateral channel (XLIF) combined with lateral or percutaneous posterior pedicle screw fixation for the treatment of lumbar spine tuberculosis.

Methods:: Twenty two patients with lumbar tuberculosis who underwent surgery with XLIF technique and internal fixation were included in the study. Their data about operative time, intraoperative blood loss, bone fusion, kyphosis correction, and clinical recovery were retrospectively collected and analyzed.

Results:: The mean intraoperative blood loss was 249.8±27.8 ml and the operative time 347.5±20.7 min. At the final follow-up, 11 to 15 months postoperatively, ESR and CRP were normal and pain (VAS) and Oswestry disability index (ODI) were significantly reduced (23.0±-3.1 vs 0.6±-0.7 and 57.2±-1.6 vs 6.4±-1.2 respectively) compared to preoperative values. Progression of the kyphotic deformity was effectively prevented (mean Cobb angle 23.9° +/-1.9° vs 24.5° +/-1.4°, P>0.05). There was one failure of the fixation associated to poor therapy adherence. All the patients showed neurological recovery.

Conclusion:: Debridement and interbody fusion by extreme lateral channel combined with lateral or percutaneous posterior pedicle screw fixation effectively retained the spine stability and provided clinical and neurologic recovery in selected patients with lumbar spine tuberculosis.

No MeSH data available.


Related in: MedlinePlus