title: One-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation and fusion in the surgical treatment of lumbo-sacral spinal tuberculosis in the aged.
abstract: Aged patients represent a high risk group for acquiring spinal tuberculosis, and it still remains a leading cause of kyphosis and paraplegia in developing nations. Aged patients often combined with cardiovascular and respiratory disease and single lung ventilation via anterior approach surgery could result in more post-operative complications. We aimed to analyze the efficacy and feasibility of surgical management of aged patients with lumbo-sacral spine tuberculosis using one-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation, and fusion.
  
  
  
  From March 2009 and July 2012, 17 aged patients with lumbo-sacral spinal tuberculosis were treated with one-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation, and fusion. There were eight male and nine female with a mean age of 63.3 years (range: 60-71 years). The mean follow-up was 46.5 months (range 38-70 months). Patients were evaluated before and after surgery in terms of ESR, neurological status, visual analog scale (VAS), and lumbosacral angle.
  
  
  
  Spinal tuberculosis was completely cured and the grafted bones were fused in all 17 patients. There were no recurrent tuberculous infections. ESR became normal within three months in all patients. The ASIA neurological classification and VAS scores improved in all cases. The average preoperative lumbosacral angle was 20.6° (range 18.1°-22.5°) and became 29.4° (range 27.1°-32.5°) at final follow-up.
  
  
  
  Our results showed that one-stage posterior focus debridement, interbody graft using titanium mesh cages, posterior instrumentation, and fusion was an effective treatment for aged patients with lumbo-sacral spinal tuberculosis. It is characterized with minimum surgical trauma, good pain relief, good neurological recovery, and good reconstruction of the spinal stability.
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, Xiang Ya Road 87, ChangSha, China.
authors.forename: Yu-Xiang
authors.initials: YX
authors.lastname: Wang
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, Xiang Ya Road 87, ChangSha, China. zhanghongqi9996@sina.com.
authors.forename: Hong-Qi
authors.initials: HQ
authors.lastname: Zhang
authors.affiliation: Department of Health Management Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Liao
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, Xiang Ya Road 87, ChangSha, China.
authors.forename: Ming-Xing
authors.initials: MX
authors.lastname: Tang
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, Xiang Ya Road 87, ChangSha, China.
authors.forename: Chao-Feng
authors.initials: CF
authors.lastname: Guo
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, Xiang Ya Road 87, ChangSha, China.
authors.forename: Ang
authors.initials: A
authors.lastname: Deng
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, Xiang Ya Road 87, ChangSha, China.
authors.forename: Jian-Huang
authors.initials: JH
authors.lastname: Wu
authors.affiliation: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, Xiang Ya Road 87, ChangSha, China.
authors.forename: Jin-Yang
authors.initials: JY
authors.lastname: Liu
mesh_terms: D000368:Aged; D003646:Debridement / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008161:Lumbosacral Region / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D013123:Spinal Fusion / Q000379:methods*; D014025:Titanium / Q000627:therapeutic use*; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000601:surgery*
chemical_list: D014025:Titanium
keywords: Lumbo-sacral; Posterior approach; Spine tuberculosis; The aged; Titanium mesh cages