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One-stage posterior focus debridement, interbody graft utilizing titanium mesh cages, posterior instrumentation and fusion within the surgical therapy of lumbo-sacral spinal tuberculosis within the aged.
Int Orthop. 2016 Jun;40(6):1117-24
Authors: Wang YX, Zhang HQ, Liao W, Tang MX, Guo CF, Deng A, Wu JH, Liu JY
Summary
PURPOSE: Aged sufferers symbolize a excessive danger group for buying spinal tuberculosis, and it nonetheless stays a number one reason behind kyphosis and paraplegia in growing nations. Aged sufferers usually mixed with cardiovascular and respiratory illness and single lung air flow through anterior method surgical procedure might end in extra post-operative issues. We aimed to research the efficacy and feasibility of surgical administration of aged sufferers with lumbo-sacral backbone tuberculosis utilizing one-stage posterior focus debridement, interbody graft utilizing titanium mesh cages, posterior instrumentation, and fusion.
METHODS: From March 2009 and July 2012, 17 aged sufferers with lumbo-sacral spinal tuberculosis had been handled with one-stage posterior focus debridement, interbody graft utilizing titanium mesh cages, posterior instrumentation, and fusion. There have been eight male and 9 feminine with a imply age of 63.three years (vary: 60-71 years). The imply follow-up was 46.5 months (vary 38-70 months). Sufferers had been evaluated earlier than and after surgical procedure when it comes to ESR, neurological standing, visible analog scale (VAS), and lumbosacral angle.
RESULTS: Spinal tuberculosis was utterly cured and the grafted bones had been fused in all 17 sufferers. There have been no recurrent tuberculous infections. ESR turned regular inside three months in all sufferers. The ASIA neurological classification and VAS scores improved in all circumstances. The common preoperative lumbosacral angle was 20.6° (vary 18.1°-22.5°) and have become 29.four° (vary 27.1°-32.5°) at closing follow-up.
CONCLUSIONS: Our outcomes confirmed that one-stage posterior focus debridement, interbody graft utilizing titanium mesh cages, posterior instrumentation, and fusion was an efficient therapy for aged sufferers with lumbo-sacral spinal tuberculosis. It’s characterised with minimal surgical trauma, good ache reduction, good neurological restoration, and good reconstruction of the spinal stability.
PMID: 26983410 [PubMed – indexed for MEDLINE]