Xu Zhengquan, Wang Xiyang, Shen Xiongjie, Luo Chengke, Wu Ping, Zeng Hao
Department of Spine Surgery, The Xiangya Hospital of Central-South University, Changsha, 410008, Hunan, China.
Eur Spine J. 2015 Aug;24(8):1800-5. doi: 10.1007/s00586-015-3863-8. Epub 2015 Mar 11.
To investigate the clinical efficacy and feasibility of surgical treatment for lumbosacral junction tuberculosis by one-stage posterior debridement, interbody fusion, lumbopelvic fixation, and postural drainage.
A total of 15 cases with lumbosacral junction tuberculosis treated by one-stage posterior debridement, interbody fusion, lumbopelvic fixation, and postural drainage in our center from January 2005 to October 2011 were studied. Lumbosacral angle, visual analog scale (VAS), and neurological performance were assessed before and after surgery.
All patients were followed for 28-56 months post-operation (average, 40.7 ± 7.7 months). No severe complications occurred. Bone fusion occurred in all patients at a mean of 8.4 months (range 6-12 months) after surgery. The mean lumbosacral angle was significantly increased from the mean preoperative angle (20.9° ± 1.8°) both post-operatively (26.5° ± 1.6°) and at final follow-up (25.3° ± 1.4°) (both P < 0.05). All patients had significant post-operative improvement in neurological performance and VAS scores.
Our results suggest that one-stage posterior debridement, interbody fusion, lumbopelvic fixation, and postural drainage can be an effective and feasible treatment option for lumbosacral junction tuberculosis, offering fewer complications and a better quality of life.
探讨一期后路清创、椎间融合、腰骶骨盆固定及体位引流治疗腰骶部结核的临床疗效及可行性。
研究2005年1月至2011年10月在本中心采用一期后路清创、椎间融合、腰骶骨盆固定及体位引流治疗的15例腰骶部结核患者。术前及术后评估腰骶角、视觉模拟评分（VAS）及神经功能。
所有患者术后随访28 - 56个月（平均40.7±7.7个月）。未发生严重并发症。所有患者术后平均8.4个月（6 - 12个月）发生骨融合。术后及末次随访时腰骶角平均度数均较术前平均度数（20.9°±1.8°）显著增加（术后为26.5°±1.6°，末次随访为25.3°±1.4°）（均P < 0.05）。所有患者术后神经功能及VAS评分均有显著改善。
我们的结果表明，一期后路清创、椎间融合、腰骶骨盆固定及体位引流可作为腰骶部结核有效且可行的治疗选择，并发症较少，生活质量较好。
