Minimally invasive direct lateral interbody fusion in the treatment of the thoracic and lumbar spinal tuberculosisMini-DLIF for the thoracic and lumbar spinal tuberculosis

Abstract

BackgroundTo investigate the clinical efficacy of minimally invasive direct lateral approach debridement, interbody bone grafting, and interbody fusion in the treatment of the thoracic and lumbar spinal tuberculosis.MethodsFrom January 2013 to January 2016, 35 cases with thoracic and lumbar spinal tuberculosis received direct lateral approach debridement, interbody bone grafting, and interbody fusion. Of the 35 cases, 16 patients were male and 19 were female and the median age was 55.2 (range 25–83). The affected segments were single interspace, and the involved vertebral bodies included: 15 cases of thoracic vertebrae (1 cases of T5/6, 2 cases of T6/7, 4 cases of T7/8, 3 cases of T8/9, 5 cases of T9/10) and 20 cases of lumbar spine (2 cases of L1/2, 6 cases of L2/3, 6 cases of L3/4, 6 cases of L4/5). After MIDLIF operation, all the patients received medication of four anti-tubercular drugs for 12 to18 months.ResultsThe patients were followed up for 7 to 40 months with an average of 18.5 months. The visual analogue scale (VAS) at the last follow-up was 2.8 ± 0.5, which was significantly different from the preoperative VAS (8.2 ± 0.7). After MIDLIF, there was 5 cases occurred with transient numbness in one side of the thigh or inguinal region, and 10 cases suffered from flexion hip weakness. All the bone grafts were fused within 6~ 18 months (average of 11.5 months) after the operation.ConclusionMinimally invasive lateral approach interbody fusion technology have the advantage of less injury and quick recovery after surgery, which is the effective and safe treatment for thoracic and lumbar spinal tuberculosis.

Characteristics and management of bone and joint tuberculosis in native and migrant population in Shanghai during 2011 to 2015

“…Arthroplasty was more appropriate for complete devastation of joint structure, with limited choices of reconstruction except artificial joint replacement [ 28 ]. For spine TB patients, they also received intervertebral disc fusion via minimal invasive operations [ 29 ]. In this study, 66 patients received joint arthrolysis and no arthroplasty was performed.…”

Neurological recovery and efficacy of posterior per‐cutaneous pedicle internal fixation combined with full‐endoscopic debridement and intravertebral bone grafting in the treatment of thoracolumbar tuberculosis

“…The MISS can reduce spinal tissue injury, the amount of bleeding, postoperative complications and speed up postoperative rehabilitation (Lehman RA Jr, et al, 2005;Verdú-López F, et al, 2017;Zhang XF et al, 2010). During interventional therapy, CT-guided drainage and irrigation for abscess or focus of spinal tuberculosis have been proved to be a minimally invasive and safe operation, but there were some problems, such as long indwelling time of postoperative drainage tube, unable to completely remove the focus, long treatment cycle and so on (Gan F, et al, 2018;Zhang XF, et al, 2010). With the development of video-assisted thoracoscopy, this technique has been successfully used in the treatment of spinal tuberculosis (Kapoor SK, et al, 2005;Lv GH, et al, 2009).…”

Lateral Lumbar Interbody Fusion, Indications and Complications—An Updated Review

“…It is typical in patients with a history of diverticulitis, radiotherapy to the abdomen, or previous abdominal surgery (nephrectomy or total colectomy). Gan et al treated thoracic and lumbar invasive tuberculosis with DLIF, they make the conclusion of less injury and quick recovery after surgery [15]. LLIF may be not suitable for active infection, but it can be used for those chronic diseases.…”