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One-stage posterior focus debridement, interbody graft utilizing titanium mesh cages, posterior instrumentation and fusion within the surgical remedy 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 characterize a excessive threat group for buying spinal tuberculosis, and it nonetheless stays a number one explanation for kyphosis and paraplegia in creating nations. Aged sufferers typically mixed with cardiovascular and respiratory illness and single lung air flow by way of anterior strategy surgical procedure may end in extra post-operative problems. 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 have 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 have been evaluated earlier than and after surgical procedure by way of ESR, neurological standing, visible analog scale (VAS), and lumbosacral angle.
RESULTS: Spinal tuberculosis was fully cured and the grafted bones have 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 instances. The common preoperative lumbosacral angle was 20.6° (vary 18.1°-22.5°) and have become 29.four° (vary 27.1°-32.5°) at ultimate 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 remedy for aged sufferers with lumbo-sacral spinal tuberculosis. It’s characterised with minimal surgical trauma, good ache aid, good neurological restoration, and good reconstruction of the spinal stability.
PMID: 26983410 [PubMed – indexed for MEDLINE]