Anterior debridement and interbody arthrodesis with posterior pedicle screw instrumentation for the treatment of tuberculosis of the lower lumbar spine / 中国矫形外科杂志

ABSTRACT

[Objective]To evaluate the clinical efficacy of posterior pedicle screw instrumentation followed by anterior debridement and bone grafting through the lateral edge of the rectus abdominal muscle and retroperitoneal approach for the treatment of tuberculosis of the lower lumbar spine. [Methods]From June 2002 to January 2007,27 patients suffering from lower lumbar tuberculosis were treated with this technique.[Results]The surgical average time and amount of bleeding was 4.3 h and 438 ml respectively.The length of anterior incision was 5~7 cm.The average time and the amount of bleeding were 21 min and 48 ml respectively during the anterior lesion exposure.The follow-up period were 12~37 months,mean 17.3 months.The average preoperative,immediate postoperative,and final follow-up local lordotic angles of the affected segments were-2.1??4.0?,4.9??1.4?,3.7??3.0?.All patients had healed of disease and there was no recurrence at final follow up.Bony fusion was obtained in all patients.[Conclusion]Anterior exposure through the lateral edge of the rectus abdominal muscle and retroperitoneal approach is simple and less invasive.The spinal stability is achieved through short-segment pedicle screw fixation while reducing the sacrifice of additional motion segments.This technique is safe and effective for the treatment of tuberculosis of the lower lumbar spine.