[Modified Galveston technology for lumbosacral tuberculosis].
OBJECTIVE
To study the clinical effects of modified Galveston technology in the treatment of lumbosacral tuberculosis.


METHODS
From January 2001 to May 2008, 19 patients with lumbosacral tuberculosis were treated, including 13 males and 6 females aged 21-58 years old (average 38 years old). The course of disease was 8-22 months. The tuberculosis was at the L4-S1 level in 3 cases, the L5, S1 level in 10 cases, the L5-S2 level in 5 cases, and the S1, 2 level in 1 case. Seven cases were complicated with neural symptom of the lower limbs, 3 cases of them were grade C and 4 cases were grade D according to the Frankel scale of nerve function. The preoperative JOA score of lower back pain was 5-22 (average 19). Six cases were complicated with iliac abscess, 3 cases with psoas abscess, 3 cases with sacroiliac joint tuberculosis, and 2 cases with pulmonary tuberculosis. For 12 patients, the operation of modified Galveston internal fixation via the posterior approach, focus debridement via vertebral canal, and interbody fusion with autogenous iliac bone fragment grafting was performed; for 7 cases, the operation of modified Galveston internal fixation via the posterior approach, vertebral lamina fusion with autogenous iliac bone fragment grafting, and anterior focus debridement was performed.


RESULTS
The incision of 18 cases was healed by first intention, and 1 case had sinus 3 weeks after operation and healed 3 months after operation. Nineteen patients were followed up for 12-82 months (average 21 months). There was no recurrence of the local tuberculosis, and the common toxic symptom of tuberculosis disappeared 6-12 months after operation. All the patients achieved bony fusion 4-6 months postoperatively, and 3 patients with sacroiliac joint tuberculosis achieved sacroiliac joint fusion. For those 7 patients with combinations of the neural symptom of the lower limbs, the symptoms disappeared and their Frankel scales were improved to grade E. The JOA score of low back pain at the final follow-up was 22-29 (average 26). There was a significant difference between preoperation and postoperation (P < 0.05).


CONCLUSIONS
The modified Galveston technology is helpful to reconstruct the stability of lumbosacral vertebrae, improve bony fusion rate, reduce the postoperative in-bed time.
Kang
Jianping
J
Department of Spinal Surgery, Affiliated Hospital of Luzhou Medical College, Luzhou Sichuan, 646000, P.R. China.
Feng
Daxiong
D
Ye
Fei
F
Li
Jun
J
D000328:Adult; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D013123:Spinal Fusion / Q000379:methods*; D014399:Tuberculosis, Spinal / Q000601:surgery*; D055815:Young Adult