Pu Fei-Fei, Peng Xiang-Lin, Zhou Fang-Zheng, Zhao Xiao-Long, Yang Ling, Cao Jun-Qing, Wei Liu, Feng Jing, Xia Ping
Department of Orthopedics, Wuhan Hospital of Traditional Chinese and Western Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, Hubei Province, China.
Department of Orthopedics, Wuhan No. 1 Hospital, Wuhan 430022, Hubei Province, China.
World J Orthop. 2025 Jul 18;16(7):106041. doi: 10.5312/wjo.v16.i7.106041.
Spinal tuberculosis, a destructive extrapulmonary form, often causes severe deformity and neurological deficits. Surgical intervention aims to debride lesions, reconstruct stability, and correct deformities. This study evaluates a combined posterior fixation and minimally invasive anterior approach for lumbar tuberculosis.
To evaluate the clinical outcomes and radiological parameters of posterior internal fixation combined with minimally invasive anterior lesion clearance and bone graft fusion for the treatment of lumbar tuberculosis.
Clinical data from 24 patients with lumbar tuberculosis who underwent posterior pedicle screw fixation combined with minimally invasive anterior lesion clearance were analyzed. The Cobb angle, visual analog scale (VAS) score, and Frankel classification were statistically assessed preoperatively and postoperatively. Complications and bone graft fusion were also recorded.
Wounds healed in the first stage in 22 patients; one patient developed a posterior incisional sinus tract, and one experienced postoperative tuberculosis recurrence. At the final follow-up, according to the Frankel classification, there were 1, 2, and 21 cases classified as grade C, grade D, and grade E, respectively. By the last follow-up, the Cobb angle, VAS score, and erythrocyte sedimentation rate had all decreased. Both X-ray and computed tomography images confirmed bone healing. The fusion time ranged from 3 to 9 months, with an average of 5.2 months.
Posterior pedicle screw fixation combined with minimally invasive anterior lesion clearance is an effective and safe treatment for lumbar tuberculosis.
脊柱结核是一种具有破坏性的肺外结核形式，常导致严重畸形和神经功能缺损。手术干预旨在清除病灶、重建稳定性并矫正畸形。本研究评估一种后路固定联合微创前路手术治疗腰椎结核的方法。
评估后路内固定联合微创前路病灶清除及植骨融合治疗腰椎结核的临床疗效和影像学参数。
分析24例行后路椎弓根螺钉固定联合微创前路病灶清除的腰椎结核患者的临床资料。对术前和术后的Cobb角、视觉模拟评分（VAS）及Frankel分级进行统计学评估。记录并发症及植骨融合情况。
22例患者伤口一期愈合；1例患者出现后切口窦道，1例术后结核复发。末次随访时，根据Frankel分级，分别有1例、2例和21例患者为C级、D级和E级。至末次随访时，Cobb角、VAS评分及血沉均下降。X线和计算机断层扫描图像均证实骨愈合。融合时间为3至9个月，平均5.2个月。
后路椎弓根螺钉固定联合微创前路病灶清除是治疗腰椎结核的一种有效且安全的方法。
