One-stage anterolateral debridement，allograft and internal fixation for lumbosacral tuberculosis

English Keywords:Lumbosacral tuberculosis  Debridement  Bone graft  Spinal fusion  Internal fixation

English Abstract:

  【Abstract】 Objective：To investigate the clinical efficacy of one-stage anterolateral debridement，allograft and internal fixation as an alternative treatment for lumbosacral tuberculosis.Method：From January 2005 to January 2007，24 patients with lumbosacral tuberculosis underwent one-stage anterolateral debridement，allograft and internal fixation.There were 17 males and 7 females with the average age of 35.8 years-old（range，17 to 58 years-old）.L4-L5 was involved in 8 patients，L5 in 5 patients，L5-S1 in 8 patients and L4-S1 in 3 patients.1 patient was classified as Frankel grade B，3 cases as grade C，2 cases as grade D and 18 cases as grade E.The mean preoperative lumbosacral angle was 19°±3.5°.Result：All patients underwent surgery successfully with lesion being removed completely.The average operating time was 150min（range，120-180min） with the mean intraoperative blood loss of 700ml（range，500-900ml）.No postoperative complication was noted. All patients recovered to be able to mobile in 2 weeks after operation with the protection of brace.All patients were followed up for 24-36 months（average，29 months）.At final follow-up，of the six patients with neurological deficit，1 patient of Frankel grade B improved to grade D，1 patient of grade C improved to grade D，2 patients of grade C improved to grade E and 2 patients of grade D improved to grade E.The mean postoperative lumbosacral angle was 26°±6.5°.No neurovascular injury，instrument failure and tuberculosis recurrence was noted.Bone union was observed in all cases with the average time of 7.8 months.Conclusion：Anterolateral debridement，allograft and internal fixation is effective to treat lumbosacral tuberculosis，which can ensure satisfactory deformity correction，spinal stability reconstruction，avoidance of bone graft displacement and early mobility after operation.