One-Stage Anterolateral Debridement, Bone Grafting, and Internal Fixation for Treating Lumbosacral Tuberculosis

Study Design: Retrospective case series. Purpose: To investigate the clinical efficacy and feasibility of one-stage anterolateral debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis. Overview of Literature: There has been no consensus regarding the optimal means of treating lumbosacral tuberculosis. The one-stage anterolateral extraperitoneal approach for radical debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis is rare in literature. Methods: Twenty-one patients with lumbosacral tuberculosis were retrospectively analyzed. All patients underwent the surgery of anterolateral debridement after regularly antituberculous drugs therapy. We evaluated the erythrocyte sedimentation rate, C-reactive protein, radiography, computed tomography, magnetic resonance imaging, visual analogue score, and Oswestry disability index before and after surgery. Results: All patients completed a follow-up survey 9-48 months after surgery. All patients' wounds healed well without chronic infection or sinus formation, and all patients with low-back pain reported relief after surgery. All cases had no tuberculosis recurrence. Solid bony fusion was achieved within 6-12 months. At final follow-up, evaluated the erythrocyte sedimentation rate decreased from $38.1{\pm}12.5$ to $11.3{\pm}7.1mm/hr$, C-reactive protein decreased from $6.2{\pm}4.2$ to $1.6{\pm}1.3mg/dL$, the visual analog scale score decreased from $4.6{\pm}1.1$ to $1.4{\pm}1.0$, the Oswestry disability index score decreased from $50.2%{\pm}11.9%$ to $13.0%{\pm}6.6%$, and the lumbosacral angle increased from $20.0^{\circ}{\pm}4.8^{\circ}$ to $29.0^{\circ}{\pm}3.9^{\circ}$ (p<0.05). Conclusions: One-stage anterolateral debridement, bone grafting, and internal instrument fixation for treating lumbosacral tuberculosis is safe and effective.