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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Research article

The efficacy of local continuous chemotherapy and postural drainage in combination with one-stage posterior surgery for the treatment of lumbar spinal tuberculosis

Authors: Yongchun Zhou, Zongrang Song, Jing Luo, Jijun Liu, Yunfei Huang, Yibin Meng, Wentao Wang, Dingjun Hao

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

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Abstract

Background

The objective of this study was to compare the outcomes of one-stage posterior surgery involving debridement, bone grafting, and instrumentation with and without local continuous chemotherapy and postural drainage for the treatment of lumbar spinal tuberculosis.

Methods

From January 2009 to January 2013, 109 patients with lumbar spinal tuberculosis were treated in our center using a posterior surgical approach. Patients underwent one-stage posterior debridement, bone grafting, and instrumentation, without (group A) and with (group B) local continuous chemotherapy and postural drainage. Clinical and radiographic results for the two groups were analyzed and compared. Clinical efficacy was evaluated based on surgery duration and blood loss. The Frankel scale was used to evaluate neurological function. A visual analog scale was used to assess low back pain. Bone graft fusion and instrumentation failure were monitored by radiography, and tuberculosis activity was monitored by erythrocyte sedimentation rate (ESR) and C-reactive protein testing.

Results

Groups A and B contained 52 and 57 patients, respectively. Patients were followed for 18–36 (mean, 26.64 ± 4.2) months. All bone grafts ultimately fused, but the fusion rate was significantly more rapid in group B [6.4 ± 0.5 (range, 5–10) months] than in group A [8.9 ± 0.6 (range, 6–12) months; P < 0.05]. At 6 weeks postoperatively, ESR levels differed significantly between groups A and B (24.6 ± 1.5 vs. 16.3 ± 1.1 mm/h; P < 0.05). ESR levels normalized in both groups at 16 weeks.

Conclusions

Local continuous chemotherapy and postural drainage effectively eliminated infection foci caused by abscess remnants and accelerated interbody bone fusion in patients with lumbar spinal tuberculosis undergoing one-stage posterior surgery involving debridement, bone grafting, and instrumentation.
Literature
1.
Lee TC, Lu K, Yang LC, Huang HY, Liang CL. Transpedicular instrumentation as an adjunct in the treatment of thoracolumbar and lumbar spine tuberculosis with early stage bone destruction. J Neurosurg. 1999;91:163–9.PubMed
2.
Huang QS, Zheng C, Hu Y, Yin X, Xu H, Zhang G, Wang Q. One-stage surgical management for children with spinal tuberculosis by anterior decompression and posterior instrumentation. Int Orthop. 2009;33:1385–90.PubMedCentralCrossRefPubMed
3.
Jain AK, Dhammi IK, Prashad B, Sinha S, Mishra P. Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach. J Bone Joint Surg. 2008;90:1477–81.CrossRef
4.
Benli IT, Acaroglu E, Akalin S, Kis M, Duman E, Un A. Anterior radical debridement and anterior instrumentation in tuberculosis spondylitis. Eur Spine J. 2003;12:224–34.PubMedCentralPubMed
5.
Pang X, Wu P, Shen X, Li D, Luo C, Wang X. One-stage posterior transforaminal lumbar debridement, 360°interbody fusion, and posterior instrumentation in treating lumbosacral spinal tuberculosis. Arch Orthop Trauma Surg. 2013;133:1033–9.CrossRefPubMed
6.
Mehta JS, Bhojraj SY. Tuberculosis of the thoracic spine: a classification based on the selection of surgical strategies. J Bone Joint Surg (Br). 2001;83:859–63.CrossRef
7.
Li J, Li XL, Zhou XG, Zhou J, Dong J. Surgical treatment for spinal tuberculosis with bilateral paraspinal abscess or bilateral psoas abscess: one-stage surgery. J Spinal Disord Tech. 2014;27:E309–14.CrossRefPubMed
8.
Sun L, Song Y, Liu L, Gong Q, Zhou C. One-stage posterior surgical treatment for lumbosacral tuberculosis with major vertebral body loss and kyphosis. Orthopedics. 2013;36:e1082–90.CrossRefPubMed
9.
Ma YZ, Cui X, Li HW, Chen X, Cai XJ, Bai YB. Outcomes of anterior and posterior instrumentation under different surgical procedures for treating thoracic and lumbar spinal tuberculosis in adults. Int Orthop. 2012;36:299–305.PubMedCentralCrossRefPubMed
10.
Buyukbebeci O, Seckiner I, Karsli B, Karakurum G, Başkonuş I, Bilge O, et al. Retroperitoneoscopic drainage of complicated psoas abscesses in patients with tuberculous lumbar spondylitis. Eur spine j off publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc. 2012;21:470–3.CrossRef
11.
Fairbank JC, Pynsent PB. The Oswestry Disability Index. Spine (Phila Pa 1976). 2000;25:2940–52.CrossRef
12.
Kim KT, Lee SH, Lee YH, Bae SC, Suk KS. Clinical outcomes of 3 fusion methods through the posterior approach in the lumbar spine. Spine. 2006;31:1351–7.CrossRefPubMed
13.
Hirakawa A, Miyamoto K, Takahiro M, Fukuta S, Hosoe H, Iinuma N, et al. Surgical outcome of 2-stage (posterior and anterior) surgical treatment using spinal instrumentation for tuberculous spondylitis. J Spinal Disord Tech. 2010;23:133–8.CrossRefPubMed
14.
Fukuta S, Miyamoto K, Masuda T, Hosoe H, Kodama H, Nishimoto H, et al. Two-stage (posterior and anterior) surgical treatment using posterior spinal instrumentation. Spine. 2003;28:E302–8.
15.
Zhang HQ, Lin MZ, Shen KY, Ge L, Li JS, Tang MX, et al. Surgical management for multilevel noncontiguous thoracic spinal tuberculosis by single-stage posterior transforaminal thoracic debridement, limited decompression, interbody fusion, and posterior instrumentation (modified TTIF). Arch Orthop Trauma Surg. 2012;132:751–7.CrossRefPubMed
16.
Guven O, Kumano K, Yalcin S, Karahan M, Tsuji S. A single stage posterior approach and rigid fixation for preventing kyphosis in the treatment of spinal tuberculosis. Spine. 1976;19:1039–43.CrossRef
17.
Pang X, Shen X, Wu P, Luo C, Xu Z, Wang X. Thoracolumbar spinal tuberculosis with psoas abscesses treated by one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural Drainage. Arch Orthop Trauma Surg. 2013;133:765–72.CrossRefPubMed
Metadata
Title
The efficacy of local continuous chemotherapy and postural drainage in combination with one-stage posterior surgery for the treatment of lumbar spinal tuberculosis
Authors
Yongchun Zhou
Zongrang Song
Jing Luo
Jijun Liu
Yunfei Huang
Yibin Meng
Wentao Wang
Dingjun Hao
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-0921-2

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