One-stage posterior debridement, bone grafting fusion, and mono-segment vs. short-segment fixation for single-segment lumbar spinal tuberculosis: minimum 5-year follow-up outcomes

Abstract

Background: To compare the clinical and radiological outcomes between posterior mono-segment and shortsegment fixation combined with one-stage posterior debridement and bone grafting fusion in treating singlesegment lumbar spinal tuberculosis (LSTB). Methods: Sixty-two patients with single-segment LSTB treated by a posterior-only approach were divided into two groups: short-segment fixation (Group A, n = 32) and mono-segment fixation (Group B, n = 30). The clinical and radiographic outcomes were analyzed and compared between the two groups. Results: The intraoperative bleeding volume, operation time, and hospitalization duration were lower in Group B than in Group A. All patients achieved the bony fusion criteria. The visual analog scale score, Japanese Orthopedic Association score, and Oswestry Disability Index were substantially improved 3 months postoperatively and at the last visit in both groups, with no significant difference between the two groups (P > 0.05). Kirkaldy-Willis functional evaluation at the final follow-up demonstrated that all patients in both groups achieved excellent or good results. The difference in the angle correction rate and correction loss between Groups A and B was not significant (P > 0.05). Conclusions: One-stage posterior debridement, bone grafting fusion, and mono-segment or short-segment fixation can provide satisfactory clinical and radiological outcomes. Mono-segment fixation is more suitable for the treatment of single-segment LSTB because the lumbar segments with normal motion can be preserved with less trauma, a shorter operation time, shorter hospitalization, and lower costs.

One-stage posterior debridement and single-segment interbody fusion for treating mono-segmental lumbar and lumbosacral spinal tuberculosis in adults following minimum 5-year follow-up

“…This pathological process results in stronger holding forces for pedicle screws in the involved vertebrae, compared with fracture [ 24 ]. Liu et al [ 25 ] compared the results of mono-segment fixation versus short-segment fixation for the treatment of single-segment lumbar spinal TB and found that mono-segment fixation was more suitable since the normal motion was preserved. Xu et al [ 26 ] reported that single-segment fixation and bone fusion was effective in maintaining the stability of the spine and retaining normal motion units.…”

One-stage posterior debridement, titanium mesh cage bone grafting and single-segment fixation for treating mono-segmental lumbar and lumbosacral spinal tuberculosis in adult patients following minimum 5-year follow-up

“…This pathological process results in stronger holding forces for pedicle screws in the involved vertebrae compared with fracture [24]. Liu et al [25] compared the results of mono-segment xation versus short-segment xation for the treatment of single-segment lumbar spinal TB and found that mono-segment xation was more suitable since the normal motion was preserved. Xu et al [26] reported that single-segment xation and bone fusion was effective in maintaining the stability of the spine and retaining normal motion units.…”

Single posterior debridement, interbody fusion, and fixation on patients with continuous multivertebral lumbar spine tuberculosis (CMLSTB)

“…They also evaluated the single posterior debridement, interbody fusion and fixation technique for lumbar CMSTB. Lumbar constitutes the lower part of the spine and bears the maximum weight, and hence, it is often associated with internal fixation failure [26]. Currently, there is no literature relevant to lumbar CMSTB.…”