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| CAO Qi,TANG Xiaojun,TANG Guojun.Single-stage focal debridement and pedicle subtraction osteotomy for lumbosacral tuberculosis complicated with kyphosis deformity[J].Chinese Journal of Spine and Spinal Cord,2011,(10):825-829. |
| Single-stage focal debridement and pedicle subtraction osteotomy for lumbosacral tuberculosis complicated with kyphosis deformity |
| Received:July 25, 2011 Revised:August 13, 2011 |
| English Keywords:Lumbosacral tuberculosis Post-tubercular kyphosis Transpedicular osteotomy Iliac screw fixation |
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| English Abstract: |
| 【Abstract】 Objective：To evaluate the clinical efficacy of single-stage focal debridement and pedicle subtraction osteotomy（PSO） for lumbosacral tuberculosis complicated with kyphosis deformity.Method：A total of 14 cases（5 males and 9 females） suffering from lumborsacral tuberculosis complicated with kyphotic deformity between 2002 and 2010 underwent one-stage focal debridement，PSO and pedicle-illiac screw fixation.The average age at surgery was 45.2 years（range，31-53 years）.Radiologic index including lumbar lordosis，lumbosacral angle，kyphotic Cobb angle，sagittal trunk shift as well as neurologic status using the modified Frankel grade and visual analogue scale（VAS） were evaluated before and after surgery.Result：The mean duration of surgery was 5.4h，and the average intraoperative blood loss was 2045ml.All patients were followed up for 6 to 36 months with an average of 23.4 months.At final follow-up，the lumbar lordosis increased from 17.0±8.4 degrees to 28.0±7.9 degrees.Lumbosacral angle increased from 10.0±6.1 degrees to 25.0±7.6 degrees.The average preoperative kyphosis was 11.0±4.7 degrees，which decreased to 4.1±3.5 degrees after operation.Sagittal trunk shift improved from 5.3±0.5cm to -3.2±0.8cm.The rate of correction for the four procedures mentioned above was （52.0±4.2）%，（61.3±5.7）%，（68.3±3.6）% and （58.0±1.4）% respectively.Three of four cases with Frankel′s C and D each had neurofunction improved to grade E after operation except for one grade C to grade D at final follow-up.The mean preoperative VAS score was 8.75 and 2.52 for final follow-up，and back pain relief reached 71.2%.No death or nerve injury was found.Two cases developed fistula formation and one had hematoma formation after operation.All patients showed bony union with an average of 7.3 months.Conclusion：Single-stage focal debridement and PSO is safe and reliable for debridement，deformity correction, stability reconstruction and maintaining sagittal alignment. |
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