Related Articles |
[Clinical application of modified inverted L-shape incision by extraperitoneal approach to lumbosacral tuberculosis].
Zhongguo Gu Shang. 2017 Sep 25;30(9):799-804
Authors: Shi SY, Hu SP, Fei J, Lai Z, Grasp GH
Summary
OBJECTIVE: To discover the medical results of one-stage posterior transpedicular screw system inner fixation mixed with anterior debridement and bone grafting with modified inverted L-shape incision by extraperitoneal method in treating a number of lumbosacral tuberculosis.
METHODS: The medical knowledge of 15 sufferers with a number of lumbosacral tuberculosis underwent operation from February 2008 to December 2014 have been retrospectively analyzed. There have been 9 males and 6 females with a median of (47.zero±13.9) years previous. The lesions concerned L?-S? in 12 circumstances, L?-S? in 1 case, L?-S? in 2 circumstances. 5 circumstances difficult with nerve root signs and a pair of circumstances with cauda equina signs. All sufferers have been handled with posterior transpedicular screw system inner fixation mixed with anterior L?,?, L?S? debridement and bone grafting with modified inverted L-shape incision by extraperitoneal method. Operation time, blood loss, incision size, first passage of gasoline by anus have been recorded. The situation of bone fusion and focus absorption have been noticed by lumbar CT and MRI; and ESR and CRP have been usually rechecked.
RESULTS: Fifteen sufferers have been adopted up for 18-24 months with a median of (20.zero±2.73) months. All lumbosacral ache obtained enchancment, and no loosening, breaking, or bone graft block loosening was discovered. The operative time of anterior-posterior method surgical procedure was 210-250 min with a median of (231.zero±12.1) min; the blood loss was 320-705 ml with a median of(495.zero±130.three) ml; the incision size was 15-21 cm with a median of (16.four±three.four) cm, and the prolonged size of inverted L-shape incision was 6 to 9 cm with a median of (7.1±2.6) cm. The time of first passage of gasoline by anus was 14 to 40 h with a median of (24.1±7.four) h after operation. All bone graft obtained fusion at last follow-up, and spinal wire signs bought restoration, ESR and CRP restored regular degree with no recurred at three months after drug withdrawal.
CONCLUSIONS: The therapy of a number of lumbosacral tuberculosis with posterior transpedicular screw system inner fixation mixed with anterior debridement and bone fusion with modified inverted L-shape incision by extraperitoneal method is possible and sensible. This methodology has benefits of little trauma, good publicity, much less issues and excessive safety.
PMID: 29455479 [PubMed – in process]