A Case of Recurrence of Spinal Tuberculosis Treatment with Posterior Approach and Followed by Successful Anterior Fusion on the Lumbosacral Spine

ABSTRACT

In the treatment of spine tuberculosis, anterior spinal fusion has been a widely accepted procedure since Hodgson and Stock in 1956 bacause of its many advantages. Posterior approch is a simplier & safer procedure. However the destructed vertebral body can not be removes completely by this procedure. A 50 years old female patient was admitted with lumbosacral tuberculosis showing massive destruction of the L5 & S1 vertebral body and abscess formation. We initially performed a curettage and debridement by the posterior approach, combined with chemotheraphy. A anterior fusion was a more risky procedure to the patient with poor general condition, severe adhesion and long destruction of the entire L5 & upper S1 vertebral body. Occurred 35 days after first operation. Curettage and debridement were again undertaken by the posterior approach on the second operation. However 45 days late, it recurred again. Therefore, we performed the anterior fusion as the third procedure and had a successful outcome. We believe that in some cases, the advantages of posterior approach and fusion may be a pitfall and should be carefully applied in the treatment of spine tuberculosis.