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Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion

BACKGROUND: Sacroiliac joint tuberculosis(SJT) is relatively uncommon, but it may cause severe sacroiliac joint destruction and functional disorder. Few studies in the literature have been presented on SJT, reports of surgical treatment for SJT are even fewer. In this study, we retrospectively revie...

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Autores principales: Zhu, Guo, Jiang, Li-Yuan, Yi, Zhang, Ping, Li, Duan, Chun-Yue, Yong, Cao, Liu, Jin-Yang, Hu, Jian-Zhong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708174/
https://www.ncbi.nlm.nih.gov/pubmed/29187182
http://dx.doi.org/10.1186/s12891-017-1866-9
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author Zhu, Guo
Jiang, Li-Yuan
Yi, Zhang
Ping, Li
Duan, Chun-Yue
Yong, Cao
Liu, Jin-Yang
Hu, Jian-Zhong
author_facet Zhu, Guo
Jiang, Li-Yuan
Yi, Zhang
Ping, Li
Duan, Chun-Yue
Yong, Cao
Liu, Jin-Yang
Hu, Jian-Zhong
author_sort Zhu, Guo
collection PubMed
description BACKGROUND: Sacroiliac joint tuberculosis(SJT) is relatively uncommon, but it may cause severe sacroiliac joint destruction and functional disorder. Few studies in the literature have been presented on SJT, reports of surgical treatment for SJT are even fewer. In this study, we retrospectively reviewed surgical management of patients with severe SJT of 3 different types and proposed to reveal the clinical manifestations and features and aim to determine the efficiency and security of such surgical treatment. METHODS: We reviewed 17 patients with severe SJT of 3 different types who underwent posterior open-window focal debridement and bone graft for joint fusion. Among them,five patients with anterior sacral abscess had anterior abscess curettage before debridement. Two patients with lumbar vertebral tuberculosis received one-stage posterior tuberculous debridement, interbody fusion and instrumentation. Follow-up was performed 36 months (26 to 45 months) using the following parameters: erythrocyte sedimentation rate(ESR), status of joint bony fusion on CT scan, visual analogue scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: Buttock pain and low back pain were progressively relieved with time. 6 months later, pain was not obvious, and ESR resumed to normal levels within 3 months. Solid fusion of the sacroiliac joint occurred within 12 months in all cases. No complications or recurrence occurred. At final follow-up, all patients had no pain or only minimal discomfort over the affected joint and almost complete functional recovery. CONCLUSIONS: Posterior open-window focal debridement and joint fusion is an efficient and secure surgical method to treat severe SJT. If there is an abscess in the front of the sacroiliac joint, anterior abscess curettage should be performed as a supplement. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12891-017-1866-9) contains supplementary material, which is available to authorized users.
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spelling pubmed-57081742017-12-06 Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion Zhu, Guo Jiang, Li-Yuan Yi, Zhang Ping, Li Duan, Chun-Yue Yong, Cao Liu, Jin-Yang Hu, Jian-Zhong BMC Musculoskelet Disord Research Article BACKGROUND: Sacroiliac joint tuberculosis(SJT) is relatively uncommon, but it may cause severe sacroiliac joint destruction and functional disorder. Few studies in the literature have been presented on SJT, reports of surgical treatment for SJT are even fewer. In this study, we retrospectively reviewed surgical management of patients with severe SJT of 3 different types and proposed to reveal the clinical manifestations and features and aim to determine the efficiency and security of such surgical treatment. METHODS: We reviewed 17 patients with severe SJT of 3 different types who underwent posterior open-window focal debridement and bone graft for joint fusion. Among them,five patients with anterior sacral abscess had anterior abscess curettage before debridement. Two patients with lumbar vertebral tuberculosis received one-stage posterior tuberculous debridement, interbody fusion and instrumentation. Follow-up was performed 36 months (26 to 45 months) using the following parameters: erythrocyte sedimentation rate(ESR), status of joint bony fusion on CT scan, visual analogue scale (VAS) and the Oswestry Disability Index (ODI). RESULTS: Buttock pain and low back pain were progressively relieved with time. 6 months later, pain was not obvious, and ESR resumed to normal levels within 3 months. Solid fusion of the sacroiliac joint occurred within 12 months in all cases. No complications or recurrence occurred. At final follow-up, all patients had no pain or only minimal discomfort over the affected joint and almost complete functional recovery. CONCLUSIONS: Posterior open-window focal debridement and joint fusion is an efficient and secure surgical method to treat severe SJT. If there is an abscess in the front of the sacroiliac joint, anterior abscess curettage should be performed as a supplement. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12891-017-1866-9) contains supplementary material, which is available to authorized users. BioMed Central 2017-11-29 /pmc/articles/PMC5708174/ /pubmed/29187182 http://dx.doi.org/10.1186/s12891-017-1866-9 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Zhu, Guo
Jiang, Li-Yuan
Yi, Zhang
Ping, Li
Duan, Chun-Yue
Yong, Cao
Liu, Jin-Yang
Hu, Jian-Zhong
Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion
title Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion
title_full Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion
title_fullStr Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion
title_full_unstemmed Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion
title_short Sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion
title_sort sacroiliac joint tuberculosis: surgical management by posterior open-window focal debridement and joint fusion
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5708174/
https://www.ncbi.nlm.nih.gov/pubmed/29187182
http://dx.doi.org/10.1186/s12891-017-1866-9
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