Cargando…

Combined anteroposterior approaches in lateral position treatment of lumbosacral tuberculous in single-stage

BACKGROUND: The local anatomy of the lumbosacral region of spine is complicated, with special biomechanical characteristics. For surgical management of tuberculous spondylitis reported in the literature, the methods would be two-stage anterior and posterior approaches or one-stage anterior and poste...

Descripción completa

Detalles Bibliográficos
Autores principales: Bai, Jianqiang, Xia, Qun, Miao, Jun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9055743/
https://www.ncbi.nlm.nih.gov/pubmed/35488329
http://dx.doi.org/10.1186/s12893-022-01612-0
_version_ 1784697481316007936
author Bai, Jianqiang
Xia, Qun
Miao, Jun
author_facet Bai, Jianqiang
Xia, Qun
Miao, Jun
author_sort Bai, Jianqiang
collection PubMed
description BACKGROUND: The local anatomy of the lumbosacral region of spine is complicated, with special biomechanical characteristics. For surgical management of tuberculous spondylitis reported in the literature, the methods would be two-stage anterior and posterior approaches or one-stage anterior and posterior approach with patient’s intraoperative position being changed. These types of surgery approaches would result in long operative duration and more intraoperative blood loss, and most important there is no coordination between anterior and posterior procedures. METHODS: The purpose of this study was to introduce a new procedure called in the lateral position single -stage combined anteriorposterior approaches for treatment of lumbosacral tuberculous spondylitis and to evaluate its preliminary surgical outcomes. Fifteen patients with lumbosacral tuberculous spondylitis who underwent single-stage anterior and posterior radical focal debridement and reconstruction in lateral position in our hospital from April 2005 to June 2012 were included in the study. There were 6 males and 9 females with the average age of 46.8 years. The tuberculous lesions involved the following regions: L3-4 in 5cases, L4-5 in 5 cases, L5-S1 in 2 cases, L4 in one case, and L5 in 2 cases. The assessment of surgical outcomes was conducted with clinical symptoms and radiological findings,including operative time, blood loss. deformity angle, Frankel grade and Kirkaldy-Willis evaluation. RESULTS: Operation posture: The right lateral position was used for 11 patients and the left lateral position was used for the remaining 4 patients. The average duration of operation for the 15 patients was 270 min. The average intraoperative blood loss was 1720 ml. The mean follow-up period was 4.2 years. There was no recurrence. The postoperative radiological findings showed that the interbody bone grafts were fixed without any dislodgment. There was significant difference between preoperative and postoperative lumbosacral lordotic angles. Kirkaldy-Willis classification rating for the 13 cases with satisfactory results. CONCLUSION: Single-stage combined anterior and posterior surgical management of lumbosacral tuberculous spondylitis with patient in lateral position can achieve radical focal debridement, anterior and posterior procedure coordination and spinal reconstruction.
format Online
Article
Text
id pubmed-9055743
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-90557432022-05-01 Combined anteroposterior approaches in lateral position treatment of lumbosacral tuberculous in single-stage Bai, Jianqiang Xia, Qun Miao, Jun BMC Surg Research BACKGROUND: The local anatomy of the lumbosacral region of spine is complicated, with special biomechanical characteristics. For surgical management of tuberculous spondylitis reported in the literature, the methods would be two-stage anterior and posterior approaches or one-stage anterior and posterior approach with patient’s intraoperative position being changed. These types of surgery approaches would result in long operative duration and more intraoperative blood loss, and most important there is no coordination between anterior and posterior procedures. METHODS: The purpose of this study was to introduce a new procedure called in the lateral position single -stage combined anteriorposterior approaches for treatment of lumbosacral tuberculous spondylitis and to evaluate its preliminary surgical outcomes. Fifteen patients with lumbosacral tuberculous spondylitis who underwent single-stage anterior and posterior radical focal debridement and reconstruction in lateral position in our hospital from April 2005 to June 2012 were included in the study. There were 6 males and 9 females with the average age of 46.8 years. The tuberculous lesions involved the following regions: L3-4 in 5cases, L4-5 in 5 cases, L5-S1 in 2 cases, L4 in one case, and L5 in 2 cases. The assessment of surgical outcomes was conducted with clinical symptoms and radiological findings,including operative time, blood loss. deformity angle, Frankel grade and Kirkaldy-Willis evaluation. RESULTS: Operation posture: The right lateral position was used for 11 patients and the left lateral position was used for the remaining 4 patients. The average duration of operation for the 15 patients was 270 min. The average intraoperative blood loss was 1720 ml. The mean follow-up period was 4.2 years. There was no recurrence. The postoperative radiological findings showed that the interbody bone grafts were fixed without any dislodgment. There was significant difference between preoperative and postoperative lumbosacral lordotic angles. Kirkaldy-Willis classification rating for the 13 cases with satisfactory results. CONCLUSION: Single-stage combined anterior and posterior surgical management of lumbosacral tuberculous spondylitis with patient in lateral position can achieve radical focal debridement, anterior and posterior procedure coordination and spinal reconstruction. BioMed Central 2022-04-29 /pmc/articles/PMC9055743/ /pubmed/35488329 http://dx.doi.org/10.1186/s12893-022-01612-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Bai, Jianqiang
Xia, Qun
Miao, Jun
Combined anteroposterior approaches in lateral position treatment of lumbosacral tuberculous in single-stage
title Combined anteroposterior approaches in lateral position treatment of lumbosacral tuberculous in single-stage
title_full Combined anteroposterior approaches in lateral position treatment of lumbosacral tuberculous in single-stage
title_fullStr Combined anteroposterior approaches in lateral position treatment of lumbosacral tuberculous in single-stage
title_full_unstemmed Combined anteroposterior approaches in lateral position treatment of lumbosacral tuberculous in single-stage
title_short Combined anteroposterior approaches in lateral position treatment of lumbosacral tuberculous in single-stage
title_sort combined anteroposterior approaches in lateral position treatment of lumbosacral tuberculous in single-stage
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9055743/
https://www.ncbi.nlm.nih.gov/pubmed/35488329
http://dx.doi.org/10.1186/s12893-022-01612-0
work_keys_str_mv AT baijianqiang combinedanteroposteriorapproachesinlateralpositiontreatmentoflumbosacraltuberculousinsinglestage
AT xiaqun combinedanteroposteriorapproachesinlateralpositiontreatmentoflumbosacraltuberculousinsinglestage
AT miaojun combinedanteroposteriorapproachesinlateralpositiontreatmentoflumbosacraltuberculousinsinglestage