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[Minimally invasive direct lateral approach debridement, interbody bone grafting, and interbody fusion combined with posterior percutaneous pedicle screw fixation for lumbar spinal tuberculosis].
Zhongguo Gu Shang. 2021 Mar 25; 34(3):228-34.ZG

Abstract

OBJECTIVE

To investigate the clinical efficacy and superiority of direct lateral interbody fusion combined with posterior percutaneous screw fixation in the treatment of lumbar tuberculosis.

METHODS

From June 2013 to August 2016, the clinical data of 83 patients with lumbar tuberculosis were retrospectively analyzed, including 55 males and 28 females, aged from 27 to 72 (49.5±13.5) years. These 83 patients were divided into two groups according to different operation methods, 35 cases in group A were treated with direct lateral interbody fusion combined with posterior percutaneous screw fixation;48 cases in group B were treated with anterior traditional extraperitoneal debridement combined with posterior internal fixation. After operation, regular quadruple antituberculosis drugs were continued for 18 months. The operation time, intraoperative blood loss, hospital stay, bone graft fusion time and complications were compared between the two groups. Visual analogue score (VAS) of lumbar pain, Oswestry Disability Index (ODI), sagittal Cobb angle, erythrocyte sedimentation rate (ESR) and C-reactive protein(CRP) values before and after operation were analyzed.

RESULTS

The operation was successfully completed in both groups, and the operation mode was not changed during operation. The operation time, intraoperative blood loss and hospital stay were (149.4±13.3) min, (354.3±69.0) ml, (9.4±1.6) d in group A and(116.8±10.0) min, (721.9±172.3) ml, (11.8±1.7) d in group B, respectively, with significant difference between the two groups (P<0.05). The follow up time was (24.2±5.1) months in group A and (24.0±5.0) months in group B, there was no significant difference between two groups (P>0.05). At the follow-up of 4 months after operation, one patient in group A was found to have enlarged psoas major abscess on the contralateral side, and was cured after secondary operation. No sinus formation, cerebrospinal fluid leakage, internal fixation loosening, fracture or distal junction kyphosis were found during follow-up. The fusion time was (5.1±1.6) months in group A and (5.1± 1.7) months in group B, there was no significant difference between two groups (P>0.05). The VAS, ODI score, sagittal Cobb angle, ESR and CRP value of the lesion segment at the last follow-up of the two groups were significantly improved (P<0.05), but there was no significant difference between two groups (P>0.05).

CONCLUSION

The two kinds of operation can obtain satisfactory clinical effect. Direct lateral interbody fusion combined with posterior percutaneous screw fixation can reduce intraoperative blood loss and hospital stay, which is conducive to early rehabilitation of patients.

Authors+Show Affiliations

Department of Spinal Surgery, Zhejiang Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China.Department of Spinal Surgery, Zhejiang Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China.Department of Spinal Surgery, Zhejiang Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China.Department of Spinal Surgery, Zhejiang Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China.Department of Spinal Surgery, Zhejiang Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China.Department of Spinal Surgery, Zhejiang Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China.

Pub Type(s)

Journal Article

Language

chi

PubMed ID

33787166

Citation

Xu, Nan-Jian, et al. "[Minimally Invasive Direct Lateral Approach Debridement, Interbody Bone Grafting, and Interbody Fusion Combined With Posterior Percutaneous Pedicle Screw Fixation for Lumbar Spinal Tuberculosis]." Zhongguo Gu Shang = China Journal of Orthopaedics and Traumatology, vol. 34, no. 3, 2021, pp. 228-34.
Xu NJ, Yu L, Gu YJ, et al. [Minimally invasive direct lateral approach debridement, interbody bone grafting, and interbody fusion combined with posterior percutaneous pedicle screw fixation for lumbar spinal tuberculosis]. Zhongguo Gu Shang. 2021;34(3):228-34.
Xu, N. J., Yu, L., Gu, Y. J., Wang, X. Z., Jiang, W. Y., & Ma, W. H. (2021). [Minimally invasive direct lateral approach debridement, interbody bone grafting, and interbody fusion combined with posterior percutaneous pedicle screw fixation for lumbar spinal tuberculosis]. Zhongguo Gu Shang = China Journal of Orthopaedics and Traumatology, 34(3), 228-34. https://doi.org/10.12200/j.issn.1003-0034.2021.03.008
Xu NJ, et al. [Minimally Invasive Direct Lateral Approach Debridement, Interbody Bone Grafting, and Interbody Fusion Combined With Posterior Percutaneous Pedicle Screw Fixation for Lumbar Spinal Tuberculosis]. Zhongguo Gu Shang. 2021 Mar 25;34(3):228-34. PubMed PMID: 33787166.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Minimally invasive direct lateral approach debridement, interbody bone grafting, and interbody fusion combined with posterior percutaneous pedicle screw fixation for lumbar spinal tuberculosis]. AU - Xu,Nan-Jian, AU - Yu,Liang, AU - Gu,Yong-Jie, AU - Wang,Xiao-Zhou, AU - Jiang,Wei-Yu, AU - Ma,Wei-Hu, PY - 2021/3/31/entrez PY - 2021/4/1/pubmed PY - 2021/4/1/medline KW - Lumbar vertebrae KW - Spinal fusion KW - Tuberculosis, spinal SP - 228 EP - 34 JF - Zhongguo gu shang = China journal of orthopaedics and traumatology JO - Zhongguo Gu Shang VL - 34 IS - 3 N2 - OBJECTIVE: To investigate the clinical efficacy and superiority of direct lateral interbody fusion combined with posterior percutaneous screw fixation in the treatment of lumbar tuberculosis. METHODS: From June 2013 to August 2016, the clinical data of 83 patients with lumbar tuberculosis were retrospectively analyzed, including 55 males and 28 females, aged from 27 to 72 (49.5±13.5) years. These 83 patients were divided into two groups according to different operation methods, 35 cases in group A were treated with direct lateral interbody fusion combined with posterior percutaneous screw fixation;48 cases in group B were treated with anterior traditional extraperitoneal debridement combined with posterior internal fixation. After operation, regular quadruple antituberculosis drugs were continued for 18 months. The operation time, intraoperative blood loss, hospital stay, bone graft fusion time and complications were compared between the two groups. Visual analogue score (VAS) of lumbar pain, Oswestry Disability Index (ODI), sagittal Cobb angle, erythrocyte sedimentation rate (ESR) and C-reactive protein(CRP) values before and after operation were analyzed. RESULTS: The operation was successfully completed in both groups, and the operation mode was not changed during operation. The operation time, intraoperative blood loss and hospital stay were (149.4±13.3) min, (354.3±69.0) ml, (9.4±1.6) d in group A and(116.8±10.0) min, (721.9±172.3) ml, (11.8±1.7) d in group B, respectively, with significant difference between the two groups (P<0.05). The follow up time was (24.2±5.1) months in group A and (24.0±5.0) months in group B, there was no significant difference between two groups (P>0.05). At the follow-up of 4 months after operation, one patient in group A was found to have enlarged psoas major abscess on the contralateral side, and was cured after secondary operation. No sinus formation, cerebrospinal fluid leakage, internal fixation loosening, fracture or distal junction kyphosis were found during follow-up. The fusion time was (5.1±1.6) months in group A and (5.1± 1.7) months in group B, there was no significant difference between two groups (P>0.05). The VAS, ODI score, sagittal Cobb angle, ESR and CRP value of the lesion segment at the last follow-up of the two groups were significantly improved (P<0.05), but there was no significant difference between two groups (P>0.05). CONCLUSION: The two kinds of operation can obtain satisfactory clinical effect. Direct lateral interbody fusion combined with posterior percutaneous screw fixation can reduce intraoperative blood loss and hospital stay, which is conducive to early rehabilitation of patients. SN - 1003-0034 UR - https://www.unboundmedicine.com/medline/citation/33787166/[Minimally_invasive_direct_lateral_approach_debridement_interbody_bone_grafting_and_interbody_fusion_combined_with_posterior_percutaneous_pedicle_screw_fixation_for_lumbar_spinal_tuberculosis]_ DB - PRIME DP - Unbound Medicine ER -