Posterior instrumentation using compressive laminar hooks and anterior interbody arthrodesis for the treatment of tuberculosis of the lower lumbar spine.
METHODS
A retrospective review with clinical and radiologic assessment was conducted.


OBJECTIVE
To demonstrate the feasibility of posterior short segment augmentation with lamina hook and anterior lumbar interbody arthrodesis in tuberculosis of the lumbar spine by evaluating clinical results, fusion status, and sagittal angle.


BACKGROUND
There are few articles in the literature describing circumferential treatment of lumbar tuberculosis. We have had significant experience with a uniform operative technique for the treatment of this relatively rare condition and report our results with a minimum 2-year follow-up.


METHODS
Twenty-three patients with tuberculosis of the lower lumbar spine underwent posterior instrumentation with laminar hooks and anterior interbody arthrodesis by a single surgeon. The clinical outcomes were evaluated with preoperative and postoperative questionnaires, and the radiographs were independently analyzed with respect to fusion status and sagittal angle. RESULTS.: The mean follow-up period was 28.7 months (range, 24-39 months). The average preoperative, immediate postoperative, and final follow-up sagittal angles were 2.7 degrees, -14.1 degrees, and -11.5 degrees, respectively. There was a mean reduction of 16.7 degrees (range, 9 degrees-23 degrees) after surgery. Two patients had a correction loss more than 5 degrees during the follow-up period. Bony fusion was obtained in all patients. There was no recurrence of the disease. CONCLUSION.: This technique appears to be effective in stabilizing the vertebrae, restoring lordosis, achieving a solid fusion, and improving clinical outcome without sacrificing additional motion segments.
Kim
Dong-Jun
DJ
Department of Orthopaedic Surgery, Ewha Womans University Hospital and Ewha Medical Research Center, Seoul, Korea. djkim@ewha.ac.kr
Yun
Yeo-Hun
YH
Moon
Seong-Hwan
SH
Riew
K Daniel
KD
D000328:Adult; D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents / Q000627:therapeutic use; D001416:Back Pain / Q000209:etiology; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004434:Early Ambulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013525:Surgical Instruments; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents