Surgical treatment of mono-segmental spinal tuberculosis using a combination of debridement and extreme lateral interbody fusion (XLIF): A retrospective study
Abstract Background This study investigated the clinical efficacy and safety of a combination of debridement and extreme lateral internal fusion (XLIF) for mono-segmental spinal tuberculosis (TB). Methods The medical records of 9 patients (aged 21–70 years; 6 males) with mono-segmental spinal TB treated at our hospital between January 2014 and November 2016 were retrospectively reviewed. The involved vertebral bodies included 2 cases each at the T6/7, L2/3 or L3/4 level and 1 case each at the T7/8, T8/9, or T9/10 level. Results All patients were successfully treated with a combination of debridement and XLIF. The mean length of the operation was 97.3 ± 20.6 min (range, 65–126 min), and the mean blood loss during surgery was 151.1 ± 25.7 ml (range, 105–185 ml). Two patients experienced sensory disturbance over the left thigh and iliopsoas muscle weakness after surgery. After a mean follow-up of 12.3 ± 3.7 months (range, 6–17 months), the mean Cobb angle decreased from 28.7 ± 6.7 degrees to 12.1 ± 3.7 degrees. The mean VAS pain score decreased from 7.2 ± 1.1 preoperatively to 2.3 ± 0.9 postoperatively. The mean bone graft fusion time was 5.6 months (range, 4.7–7.2 months). At the final follow-up, spinal cord injuries were evaluated as ASIA Grade D in 5 patients and ASIA Grade E in 4 patients. Conclusions A combination of debridement and XLIF is effective for the treatment of mono-segmental spinal TB, and is associated with minimal intraoperative trauma, few complications, and an improved quality of life for patients. Trial registration: This was a retrospective study. The study was approved by the institutional review board and the committee of our hospital. Informed consent to use their data was obtained from all patients before surgery.