Clinical evaluation of the stability of single-segment short pedicle screw fixation for the reconstruction of lumbar and sacral tuberculosis lesions.
BACKGROUND
The routine surgical approach to posterior reconstruction in spinal tuberculosis is short- or long-segment fixation and/or fusion. This method sacrifices movement at more than one vertebral level, limits normal movement of the spinal column, and leads to degeneration of the small joints of the adjacent levels. Surgical techniques that reduce the number of fixed vertebral levels and maximize the retention of movement of the spinal column are of current interest in the treatment of spinal tuberculosis.


METHODS
A total of 106 patients with lumbosacral tuberculosis were randomly divided into two groups: a single-segment fixation group and a short-segment fixation group. After posterior correction and internal fixation, all patients underwent anterior radical debridement and interbody fusion with bone grafting.


RESULTS
The mean postoperative follow-up period was 58.09 ± 17.01 months. The average bone graft healing time was 4.35 ± 1.04 months in the single-segment group and 4.47 ± 1.10 months in the short-segment group. In the single-segment group, correction of the Cobb angle was 14.47 ± 3.76° and the loss rate was 7.22 %, and in the short-segment group, correction of the Cobb angle was 16.20 ± 2.70° and the loss rate was 6.37 % (P < 0.05). Patients with operative time, blood loss, costs in the single-segment group were significantly reduced than the short-segment group (P < 0.05).


CONCLUSIONS
Single-segment pedicle screw fixation and correction surgery can fix and fuse the diseased segment in lumbar and sacral tuberculosis, retain normal movement in the adjacent spinal column, and promote functional recovery of the spinal column postoperatively. It was be regarded as a cost-effective means of treatment with lumbar and sacral tuberculosis.
Department of Spinal Surgery, General Hospital of Ningxia Medical University, 804 Shengli Street, Yinchuan 750004, Ningxia Hui Autonomous Region, China.
Weidong
W
Jin
Zili
Z
Wang
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001863:Bone Screws; D016025:Bone Transplantation; D003646:Debridement; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012447:Sacrum / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D055815:Young Adult
D000995:Antitubercular Agents