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| Effect of Local Continuous Chemotherapy and Postural Drainage in Stage I Posterior Debridement, Bone Grafting and Instrumentation for the Treatment of Lumbar Spinal Tuberculosis |
| XIAO Pei-fen, LUO Jing |
| Department of Orthopedic, Shaanxi Provincial People's Hospital, Xi'an, Shanxi, 710068, China |
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Abstract 【Objective】 To investigate the effect of local continuous irrigation and chemotherapy on lumbar tuberculosis in stage I posterior debridement, bone graft fusion and internal fixation. 【Methods】From January 2010 to January 2014, 55 consecutive patients with lumbar tuberculosis were treated in our hospital. Among them, 30 patients underwent stage I posterior debridement, bone graft fusion and internal fixation (group A), and 25 patients underwent stage I posterior debridement, bone graft fusion and internal fixation combined with local continuous irrigation and chemotherapy (group B). The clinical efficacy and imaging results of the two groups were compared. 【Results】All patients were followed up for 23 (12~36) months. The intervertebral bone graft fusion time in the group B was 6.5 (5~10) months, which was significantly shorter than that in the group A [8.5 (6~12) months] (P<0.05). Erythrocyte sedimentation rate (ESR) in the group B was significantly lower than that in the group A at 6 weeks after operation (P<0.05), but ESR returned to normal at the last follow-up. The neurological symptoms of the two groups recovered to varying degrees. The wounds healed in the first stage. No chronic sinus formation, internal fixation rupture, loosening and other phenomena occurred in either group. 【Conclusion】The treatment of lumbar tuberculosis by posterior debridement, bone graft fusion and internal fixation combined with local continuous irrigation and chemotherapy can significantly accelerate the fusion of bone graft and the regression of inflammation, which is worthy of clinical application.
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Received: 01 August 2018
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[1] Huang QS,Zheng C,Hu Y,et al. One-stage surgical management for children with spinal tuberculosis by anterior decompression and posterior instrumentation[J].Int Orthop,2009,33(5): 1385-1390.
[2] Jain AK, Dhammi IK, Prashad B, et al. Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach[J].J Bone Joint Surg Br, 2008, 90 (11): 1477-1481.
[3] Prabhakar MM,Thakker T. Anterior decompression for cervicothoracic pathology:a study of 14 patients[J].J Spinal Cord Med,2006,29(2): 163-166.
[4] Lee CK, Vessa P, Lee JK. Chronic disabling low back pain syndrome caused by internal disc derangements. The results of disc excision and posterior lumbar interbody fusion[J].Spine,1995,20 (3): 356-361.
[5] Korovessis P, Petsinis G, Koureas G, et al. Anterior surgery with insertion of titanium mesh cage and posterior instrumented fusion performed sequentially on the same day under one anesthesia for septic spondylitis of thoracolumbar spine: is the use of titanium mesh cages safe ?[J]. Spine,2006, 31( 9) : 1014-1019.
[6] Li J, Li XL, Zhou XG, et al. Surgical treatment for spinal tuberculosis with bilateral paraspinal abscess or bilateral psoas abscess: one-stage surgery[J].J Spinal Disord Tech, 2014, 27(8): E309-E314.
[7] Guven O, Kumano K, Yalcin S,et al. A single stage posterior approach and rigid fixation for preventing kyphosis in the treatment of spinal tuberculosis[J].Spine, 1976, 19(9):1039-1043.
[8] Ma YZ, Cui X, Li HW, et al.Outcomes of anterior and posterior instrumentation under different surgical procedures for treating thoracic and lumbar spinal tuberculosis in adults[J].Int Orthop,2012, 6(2):299-305. |
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2019, Vol. 36 
