title: Treatment of lumbosacral spinal tuberculosis by one-stage anterior debridement and fusion combined with dual screw-rod anterior instrumentation underneath the iliac vessel.
abstract: BACKGROUND
  There has been no consensus regarding what is the optimal means of treating lumbosacral segment tuberculosis. The aim of this study was to evaluate the clinical outcomes of our newly developed one-stage anterior debridement and fusion combined with dual screw-rod construct anterior instrument underneath the iliac vessels for lumbosacral spinal tuberculosis.
  
  
  METHODS
  We retrospectively reviewed 22 patients with lumbosacral spinal tuberculosis who underwent one-stage anterior debridement and fusion combined with dual screw-rod anterior instrument underneath the iliac vessels between January 2004 and June 2013. We assessed the visual analogue scale (VAS), erythrocyte sedimentation rates (ESR), neurological performance, kyphotic angles, fusion rates, and computed tomographic angiography (CTA) before and after surgery.
  
  
  RESULTS
  All patients were followed-up for a mean of 46.59 months. There were no instances of spinal tuberculosis recurrence. The mean VAS scores and ESR decreased significantly from the preoperative levels both postoperatively and at the final follow-up (all P <0.001). The mean kyphotic angle significantly increased from the mean preoperative angle both postoperatively and at the final follow-up (both P <0.001). All patients had bone fusion at a mean of five months after surgery. No postoperative vascular complications were observed.
  
  
  CONCLUSIONS
  Our findings suggest that anterior radical debridement, fusion combined with dual screw-rod anterior instrument underneath the iliac vessels can be an effective and safe treatment option for lumbosacral segment tuberculosis.
authors.affiliation: Department of Orthopaedic Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwulu, Xi'an, 710004, Shaanxi, P.R China.
authors.forename: Ting
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwulu, Xi'an, 710004, Shaanxi, P.R China. hexijing88@yeah.net.
authors.forename: Xijing
authors.initials: X
authors.lastname: He
authors.affiliation: Department of Orthopaedic Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwulu, Xi'an, 710004, Shaanxi, P.R China.
authors.forename: Haopeng
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University, 157 Xiwulu, Xi'an, 710004, Shaanxi, P.R China.
authors.forename: Siyue
authors.initials: S
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D001863:Bone Screws; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007084:Iliac Vein / Q000000981:diagnostic imaging; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012447:Sacrum / Q000000981:diagnostic imaging / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000601:surgery*
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