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Posterior intervertebral house debridement, annular bone grafting and instrumentation for remedy of lumbosacral tuberculosis.
BMC Surg. 2017 Dec 04;17(1):124
Authors: Li W, Liu J, Gong L, Zhou Y, Duan D
Summary
BACKGROUND: The selection of surgical strategies for lumbosacral tuberculosis is controversial because of the complicated anterior anatomy and peculiar biomechanics of the lumbosacral junction. The target of this examine was to discover the medical impact of posterior intervertebral house debridement with annular bone graft fusion and fixation for the remedy of lumbosacral tuberculosis.
METHODS: We retrospectively analysed information from 23 sufferers with lumbosacral tuberculosis who had undergone posterior intervertebral house debridement with annular bone fusion and fixation between January 2008 and September 2014. The imply age of the sufferers was 49.zero years (vary, 27-71), and the imply period of illness till remedy was 10.2 months (vary, 6-20). The lumbosacral angle, visible analogue scale (VAS) rating, erythrocyte sedimentation charge (ESR), C-reactive protein (CRP) degree, American Spinal Damage Affiliation (ASIA) grade and Social Functioning-36 (SF-36) rating had been decided to establish the medical results of the remedy.
RESULTS: All sufferers underwent follow-up remark. The imply follow-up time was 34.2 months (vary, 18-45), the imply operation time was 167.zero min (vary, 130-210) and the imply blood loss was 767.four ml (vary, 500-1150). The lumbosacral angle was 21.zero°?±?2.1° earlier than operation, rising to 28.eight°?±?1.7° after operation (p?<?zero.05) and being maintained thereafter. The imply VAS rating earlier than operation was eight.1?±?zero.6, reducing to 1.2?±?zero.5 (p?<?zero.05) on the last follow-up. The imply ESR and CRP values had been 49.1?±?5.6 mm and 64.9?±?11.9 mg/L, respectively, earlier than operation, reducing to regular on the last follow-up. The preoperative ASIA grade was C in 6 sufferers, D in 12 and E in 5. On the last follow-up, all sufferers had an ASIA grade of E apart from one affected person with a grade of D. For all sufferers, the SF-36 rating on the last follow-up was larger than the preoperative and postoperative scores.
CONCLUSIONS: Posterior intervertebral house debridement with annular bone graft fusion and fixation is an efficient remedy for lumbosacral backbone tuberculosis.
PMID: 29202743 [PubMed – indexed for MEDLINE]