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eISSN: 1643-3750

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Treatment of Lumbar Tuberculosis by Mini-Open Anterior Approach Focal Cleaning Combined with Posterior Internal Fixation

Xiao-zhang Ying, Shi-yuan Shi, Qi Zheng, Jian Shen, Bo Zhu, Yang-hui Jin, Yi-fang Wang

(Department of Orthopaedics, Integrated Chinese and Western Medicine Hospital of Zhejiang Province, Hangzhou, Zhejiang, China (mainland))

Med Sci Monit 2017; 23:4158-4165

DOI: 10.12659/MSM.902458


BACKGROUND: The aim of this study was to evaluate the efficiency and clinical outcomes of mini-open anterior approach focal cleaning combined with posterior internal fixation compared to conventional anterior extraperitoneal approach focal cleaning combined with posterior internal fixation in the treatment of lumbar tuberculosis (TB).
MATERIAL AND METHODS: Medical records from 124 patients were collected from February 2010 to April 2015; patients were divided into two groups: group A (mini-open anterior approach focal cleaning combined with posterior internal fixation) and group B (conventional anterior extraperitoneal approach focal cleaning combined with posterior internal fixation in period I). The data on postoperative mechanical ventilation time, preoperative, postoperative, and last follow-up Cobb angle, visual analog scale (VAS), erythrocyte sedimentation rate (ESR), and Frankel classification were collected and analyzed. Operative complications, internal stability, and bone graft fusion were also observed.
RESULTS: All patients were followed-up for 12 to 36 months (average 22.5 months). Seven cases (five in group A and two in group B) had side psoas abscess and were cured after secondary drainage surgery. The rest of the cases were all cured after primary surgery, with no formation of sinus, incisional hernia, cerebrospinal fluid leakage, or recurrence of spinal TB, with no TB symptoms. Bone graft fusion ranged from 3 to 8 months (average 4.7 months). Compared to group B, group A, which had less time on postoperative mechanical ventilation, had a higher VAS score. Both groups had distinct improvements in Cobb angle, ESR, and Frankel classification after surgery.
CONCLUSIONS: Treating lumbar TB by mini-open anterior approach focal cleaning combined with posterior internal fixation was safe and effective.

Keywords: Internal Fixators, Lumbar Vertebrae, Surgery Department, Hospital

This paper has been published under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.
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