Comparison of Anterior only and Combined Anterior and Posterior Approach in Treating Lumbosacral Tuberculosis

A combined anterior and posterior (AP) surgical approach is a popular treatment modality of lumbosacral tuberculosis, but it is often traumatic and complicated. The present study aims to find whether the anterior only approach with the ARCH plate system is less invasive than the AP approach in treat...

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Bibliographic Details
Published in:Scientific reports 2019-12, Vol.9 (1), p.18475-9, Article 18475
Main Authors: Sun, Dong, Zhang, Ze-Hua, Mei, Gang, Hou, Tian-Yong, Li, Yang, Xu, Jian-Zhong, Luo, Fei
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Bone Plates
Debridement
Female
Humans
Lumbar Vertebrae - surgery
Male
Middle Aged
Patients
Pedicle Screws
Retrospective Studies
Sacrum - surgery
Spinal Fusion - methods
Spine
Treatment Outcome
Tuberculosis
Tuberculosis, Spinal - surgery
Vertebrae
Young Adult
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Summary:A combined anterior and posterior (AP) surgical approach is a popular treatment modality of lumbosacral tuberculosis, but it is often traumatic and complicated. The present study aims to find whether the anterior only approach with the ARCH plate system is less invasive than the AP approach in treating lumbosacral tuberculosis. The ARCH plate system is an innovative anatomic lumbosacral anterior multi-directional locking plate system which was devised with due consideration to the anatomic features of the lumbosacral spine and irregular destruction of involved vertebral endplates. In this retrospective study, 32 patients with lumbosacral tuberculosis underwent surgeries via either the anterior only approach (ARCH group, 18 patients) using the ARCH system or the conventional combined anterior and posterior approach (AP group, 14 patients). American Spinal Injury Association (ASIA) scores, Visual Analogue Scale (VAS) scores, Oswestry Disability Index (ODI), bone union status, ESR, CRP, intervertebral foraminal height between L5 and S1, the vertical height between the anterior upper edge of L5 and S1 vertebral body, lumbosacral angle, and the physiological lordosis of between L1 and S1 from both groups were recorded and compared. All patients were followed up for at least two years. The average duration of operation, blood loss, and length of hospital admission of the ARCH group (154.6 min, 361.1 ml&18.3days) was significantly smaller and shorter(p 
ISSN:2045-2322
2045-2322
DOI:10.1038/s41598-019-53800-3