HE Maolin,XIAO Zengming,Li Shide.One-stage anterolateral debridement,allograft and internal fixation for lumbosacral tuberculosis[J].Chinese Journal of Spine and Spinal Cord,2009,(11):818-822.
One-stage anterolateral debridement,allograft and internal fixation for lumbosacral tuberculosis
Received:April 23, 2009  Revised:June 25, 2009
English Keywords:Lumbosacral tuberculosis  Debridement  Bone graft  Spinal fusion  Internal fixation
Fund:广西科学基金资助项目(编号:桂科青0991023)
Author NameAffiliation
HE Maolin The Spine and Osteopathy Departmentthe First Affiliated Hospital of Guangxi Medical UniversityNanning530021China 
XIAO Zengming  
Li Shide  
黄成彬  
李挺松  
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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.
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