One stage anterior debridement, bone fusion and internal fixation for the treatment of lumbosacral tuberculosis / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To explore the clinical effect of the anterior debridement,bone fusion, single screw-rod fixation for the treatment of lumbosacral tuberculosis.</p><p><b>METHODS</b>From March 2005 to February 2011,18 patients with lumbosacral (L3-S1) tuberculosis (including 13 males and 5 females with an average age of 38.5 years old ranging from 24 to 61 years) were treated with removing focus completely, large piece of iliac bone strut grafting, single screw-rod vertebral lateral anterior internal fixation through anterior extraperitoneal approach. The process segment was L3,4 in 2 cases, L4,5 in 5, L4 in 2, L5S1 in 6, L4-S1 in 3. All patients were routinely treated with antituberculous druy for 12-18 months after operation, erythrocyte sedimentation rate and liver function, X-ray films, CT examination, were statedly rechecked, and condition of antituberculosis treatment and bone grafting fusion were detected.</p><p><b>RESULTS</b>Intraoperative focus were exposed clearly, debrided thoroughly. There were no large blood vessels, nerves, ureteral injury and other serious complications during operation. All patients were followed up form 6 to 42 months with an average of 13 months. Internal fixations were not loosening,breaking; bone of grafting was not displacement and obtained good healing; erythrocyte sedimentation rate and C-reactive protein were normal; tuberculosis lesions were not recurrence.</p><p><b>CONCLUSION</b>Through anterior extraperitoneal approach to remove focus, bone fusion, single screw-rod fixation in treating lumbosacral tuberculosis can complete cut lesion and rebuild the stability of lumbosacral vertebrae,in this area with a single screw and rod fixation is a feasible method.</p>