1 湘潭市中心医院脊柱外科，湖南 湘潭 411100
2 中南大学湘雅医院脊柱外科，长沙 410008
One-stage posterior debridement, compact bone grafting and posterior single-segment fixation for mono-segmental lumbar tuberculosis
This work was supported by the National Natural Science Foundation (81672191) and Xiangtan Science and Technology Project (SF-YB20181007), China.
Objective: To study the feasibility and clinical effect of one-stage posterior debridement, compact bone grafting and posterior single-segment fixation for mono-segmental lumbar tuberculosis. Methods: Twenty-eight patients with mono-segmental lumbar tuberculosis collected from December 2011 to December 2015 were studied retrospectively. The age ranged from 29 to 72 years with average years of 50.9±11.7, and the Cobb angle of preoperative lesion segment was 13°–25° (16.6±3.0)°. Preoperative ASIA nerve function classification: grade B in 1 case, grade C in 2 cases, grade D in 16 cases, grade E in 9 cases. All patients were treated with one-stage posterior debridement, compact bone grafting and posterior single-segment fixation. Result: All patients were followed up for 42 to 60 months, with an average of (50.5±5.5) months, and no serious complications occurred. The Cobb angle after operation was 5°–12°, with an average of (8.1±1.6)°, and the last follow-up was 7°–12°, with an average of (9.4±1.4)°, which was significantly improved compared with that before the operation (P<0.05). At the last follow-up, according to ASIA grade, 1 case recovered from grade B to grade D, 2 cases from grade C to grade E, and 16 cases from grade D to grade E. The visual simulation score (VAS) was significantly improved compared with that before the operation (P<0.05). All patients achieved bone graft fusion in 6 to 15 months after the operation, with an average of (9.4±2.5) months. Conclusion: The one-stage posterior debridement, compact bone grafting and posterior single-segment fixation is safe and effective with few complications, and the postoperative quality of life of patients is improved for patients with mono-segmental lumbar tuberculosis who meet the indications for surgery.
one-stage posterior; single-segment fixation; compact bone grafting; spinal fusion operation; mono-segmental lumbar tuberculosis