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Li JH, Zhang ZH, Shi T, Dai F, Zhou Q, Luo F, Hou TY, He QY, Deng MY, Xu JZ. Surgical treatment of lumbosacral tuberculosis by one-stage debridement and anterior instrumentation with allograft through an extraperitoneal anterior approach. J Orthop Surg Res 2015; 10:62. [PMID: 25958001 PMCID: PMC4490715 DOI: 10.1186/s13018-015-0204-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 03/14/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was aimed to investigate the clinical outcome of lumbosacral tuberculosis treatment by one-stage radical debridement with bone allograft reconstruction and anterior instrumentation via a retroperitoneal approach. METHODS We retrospectively analyzed a series of 43 patients with lumbosacral tuberculosis in whom the lumbosacral junction was exposed via an anterior midline retroperitoneal approach. After radical debridement, two parallel tricortical iliac crest bone allografts were placed to reconstruct the anterior column, and then anterior fixation was performed. RESULTS The mean follow-up period was 34 months (range, 24-91 months), during which no obvious loss of correction was observed. No case experienced recurrence, tuberculous peritonitis, erectile dysfunction, or retrograde ejaculation. CONCLUSIONS The midline retroperitoneal approach provides direct and safe access to lesions of lumbosacral tuberculosis. Two parallel structural iliac crest allografts and anterior instrumentation effectively stabilize the lumbosacral junction.
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Affiliation(s)
- Jian-Hua Li
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Gaotanyan Street 29, Shapingba District, Chongqing, 400038, China.
| | - Ze-Hua Zhang
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Gaotanyan Street 29, Shapingba District, Chongqing, 400038, China.
| | - Tao Shi
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Gaotanyan Street 29, Shapingba District, Chongqing, 400038, China.
| | - Fei Dai
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Gaotanyan Street 29, Shapingba District, Chongqing, 400038, China.
| | - Qiang Zhou
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Gaotanyan Street 29, Shapingba District, Chongqing, 400038, China.
| | - Fei Luo
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Gaotanyan Street 29, Shapingba District, Chongqing, 400038, China.
| | - Tian-Yong Hou
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Gaotanyan Street 29, Shapingba District, Chongqing, 400038, China.
| | - Qing-Yi He
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Gaotanyan Street 29, Shapingba District, Chongqing, 400038, China.
| | - Mo-Yuan Deng
- National & Regional United Engineering Laboratory of Tissue Engineering, Southwest Hospital, Third Military Medical University, Chongqing, China.
| | - Jian-Zhong Xu
- Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Gaotanyan Street 29, Shapingba District, Chongqing, 400038, China.
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Xu W, Wei X, Wei K, Cao X, Zhong S. A mesoporous silicon/poly-(dl-lactic-co-glycolic) acid microsphere for long time anti-tuberculosis drug delivery. Int J Pharm 2014; 476:116-23. [DOI: 10.1016/j.ijpharm.2014.09.040] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 09/15/2014] [Accepted: 09/26/2014] [Indexed: 12/01/2022]
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Zhu M, Wang H, Liu J, He H, Hua X, He Q, Zhang L, Ye X, Shi J. A mesoporous silica nanoparticulate/β-TCP/BG composite drug delivery system for osteoarticular tuberculosis therapy. Biomaterials 2011; 32:1986-95. [PMID: 21163519 DOI: 10.1016/j.biomaterials.2010.11.025] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2010] [Accepted: 11/14/2010] [Indexed: 10/18/2022]
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Expert's comment concerning Grand Rounds case entitled "Closing-opening wedge osteotomy for severe, rigid thoraco-lumbar post-tubercular kyphosis" (by S. Rajasekaran, P. Rishimugesh Kanna and Ajoy Prasad Shetty). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2010; 20:349-50. [PMID: 20725753 PMCID: PMC3048227 DOI: 10.1007/s00586-010-1528-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Indexed: 11/25/2022]
Abstract
Prevention or correction of severe kyphotic deformity in addition to eradication of the infective focus has become the modern standard of management of tuberculosis of the spine. Circumferential excision of the kyphus is now technically feasible with the development of rigid pedicle screw fixation system and intraoperative spinal cord monitoring in the past two decades.
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