title: A novel indication for a method in the treatment of lumbar tuberculosis through minimally invasive extreme lateral interbody fusion (XLIF) in combination with percutaneous pedicle screws fixation in an elderly patient: A case report.
abstract: BACKGROUND
  To describe a novel indication for a method through minimally invasive extreme lateral interbody fusion (XLIF) in combination with percutaneous pedicle screwsfixation in the treatment of lumbar tuberculosis (TB) in an elderly patient, and its clinical efficacy and feasibility. Lumbar TB is a destructive form of TB. Antituberculous treatment should be started as early as possible. In some circumstances, however, surgical debridement with or without stabilization of the spine appears to be beneficial and may be recommended. Surgeries through the approach of anterior or posterior are still challenging and often involve some complications.
  
  
  METHODS
  The case is a 68-year-old female who was misdiagnosed as simple vertebral compression fracture and underwent L1 and L2 percutaneous vertebroplasty in another hospital 7 years ago. He complained of lumbosacral pain for 1 month this time. Magnetic resonance imaging (MRI) and computed tomography (CT) showed intervertebral space in L1/2 was seriously damaged like TB.
  
  
  METHODS
  Lumbar tuberculosis INTERVENTIONS:: Antitubercular drugs, mini-invasive debridement with XLIF in combination with percutaneous pedicle screwsfixation was performed. This patient was followed up for 12 months.
  
  
  RESULTS
  No obvious complication occurred during the operation and the wound healed well. Oswestry Disability Index (ODI: 56 vs 22) and visual analog scale (VAS: 4 vs 0) score significantly decreased atfinal follow-up of 12 months. Obvious recovery of kyphosis angle was found postoperatively (post: 14.8° vs pre: 33.5°). No recurrent infection occurred at the last follow-up.
  
  
  CONCLUSIONS
  Mini-invasive surgery by debridement through XLIF and percutaneous pedicle screwsfixation may be an effective and innovative treatment method for lumbar TB in the elderly.
authors.affiliation: Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.
authors.forename: Qiyou
authors.initials: Q
authors.lastname: Wang
authors.forename: Yichun
authors.initials: Y
authors.lastname: Xu
authors.forename: Ruiqiang
authors.initials: R
authors.lastname: Chen
authors.forename: Jianwen
authors.initials: J
authors.lastname: Dong
authors.forename: Bin
authors.initials: B
authors.lastname: Liu
authors.forename: Limin
authors.initials: L
authors.lastname: Rong
mesh_terms: D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001863:Bone Screws; D003131:Combined Modality Therapy; D003646:Debridement; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007738:Kyphosis; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013526:Surgical Mesh; D014394:Tuberculosis, Osteoarticular / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*
chemical_list: D000995:Antitubercular Agents