Clinical efficacy of one-stage anterolateral surgical treatment for lumbosacral spine tuberculosis by bilateral pedicle-screw internal fixation

Objective: To investigate and evaluate the clinical efficacy of one-stage anterolateral surgical treatment for lumbosacral spine tuberculosis by bilateral pedicle-screw internal fixation. Methods: A total of 8 patients with lumbosacral spinal tuberculosis whose lesion location was between L4-5 and L5-S1 and who were admitted and treated in our hospital from October 2014 to December 2015 were selected as the research subjects. After receiving standardized anti-tuberculosis treatment for more than 4 weeks, the patients with lumbosacral spine tuberculosis were treated with the one-stage anterolateral surgery by the bilateral internal fixation. After operation, they also underwent the conventional anti-tuberculosis treatment, then their erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, lumbosacral angles, intervertebral altitude and Visual Analogue Scale (VAS) were compared and analyzed and the follow-up visits were carried out to observe their surgical results, clinical functions, complications and recurrences until December 2016. Results: The operation was successful for all patients and the follow-up visits were carried out for 12-24 months with an average of 16 months. Compared with the preoperative condition, the ESR and CRP level were decreased significantly one month after operation (all P<0.05), and returned to normal value after the reexamination at postoperative 6 months. Compared with the preoperative condition, the VAS score were improved obviously 6 month after operation (P<0.05), and patients' persistent low back pain was significantly relieved. In addition, patients' lumbosacral angles were also improved distinctly at postoperative 6 months (P<0.05). The average intervertebral space height was 10.5 mm 6 months after surgery, whose average altitude brace was 2.6 mm compared with the preoperative, with statistically significant difference (P<0.05). Moreover, patients' postoperative bone graft fusion and internal fixation were favorable, all of which achieved satisfying functional recovery results. The average time of bone graft fusion was 7-8 months. And during the follow-up period, there were no complications (such as screw rapture, breakage, and looseness) occurring and no tuberculosis recurrence. Conclusion: The efficacy of one-stage anterolateral surgery by the bilateral internal fixation in the treatment of lumbosacral spine tuberculosis is significant, with advantages of less postoperative complications and lower recurrence rate. Therefore, it is a safe and effective method for treating the lumbosacral spine tuberculosis.