Single posterior debridement, interbody fusion, and fixation on patients with continuous multivertebral lumbar spine tuberculosis (CMLSTB)

BackgroundPatients with continuous multi-vertebral lumbar spine tuberculosis (CMLSTB) were subjected to single posterior debridement, interbody fusion, and fixation to explore their clinical outcomes.MethodsSixty-seven CMLSTB patients who underwent single posterior debridement interbody fusion and fixation between January 2008 to December 2017 were studied. The operation time, blood loss, perioperative complication rate, cure rate, Visual Analog Scale (VAS), Oswetry disability index (ODI), Japanese Orthopedic Association (JOA), Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb's angle and time of interbody fusion were analyzed to understand their therapeutic effects on CMLSTB patients.ResultsThe patients were followed up for 20-48months, with a mean of 24.3months. The mean operation time was 215.5min (range, 120-280min), whereas 818.0ml of blood was lost (range, 400-1500ml) with a perioperative complication rate of 6.0% and a cure rate of 95.5%. During the last phase of follow-up, the mean preoperative VAS score (5.7) and ODI (72.0%) decreased significantly to 1.4 (t=31.4, P<0.01) and 8.4% (t=48.4, P<0.01), respectively. Alternatively, the mean preoperative ESR and CRP (74.7mm /h and 69.3mg/L, respectively) decreased to average values (t(ESR)=39.7, P-ESR<0.001; t(CRP)=50.2, P-CRP<0.001), while the JOA score (13.9) significantly increased to 23.0 (t=-11.6, P<0.01). The preoperative kyphotic Cobb's angle (20.5 degrees) decreased to 4.8 degrees after the operation (t=14.0, P<0.01); however, the kyphotic correction remained intact at the time of follow-up (t=-0.476, P=0.635). Furthermore, the mean of interbody fusion time was identified to be 8.8months (range, 6-16months).ConclusionSingle posterior debridement, interbody fusion, and fixation may be one of the surgical choices for the treatment of CMLSTB patients.