scholarly journals One-stage posterior debridement, titanium mesh cage bone grafting and single-segment fixation for treating mono-segmental lumbar and lumbosacral spinal tuberculosis in adult patients following minimum 5-year follow-up

2020 ◽  
Author(s):  
Zhenchao Xu ◽  
Xiyang Wang ◽  
Zheng Liu
Keyword(s):  
Bone Grafting ◽  
Spinal Tuberculosis ◽  
Adjacent Segment ◽  
Titanium Mesh ◽  
Titanium Mesh Cage ◽  
Single Segment ◽  
One Stage ◽  
Mesh Cage ◽  
Posterior Debridement

Abstract Background To evaluate the mid-long term outcomes of surgical management of mono-segmental lumbar and lumbosacral spinal tuberculosis (TB) by one-stage posterior debridement, titanium mesh cage bone grafting and single-segment fixation. Methods A total of 62 patients with mono-segmental lumbar or lumbosacral spinal tuberculosis were enrolled. One-stage posterior debridement, titanium mesh cage bone grafting and single-segment fixation was performed. Clinical and radiographic outcomes were compared and analyzed. Results All patients were followed up for an average of 75.0 ± 11.5 months and completely cured at the final follow-up. C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) returned to normal within three months postoperatively. Postoperative Japanese Orthopedic Association (JOA) score, visual analog scale (VAS) and Oswestry Disability index (ODI) were significantly improved compared with preoperative values. Bony fusion occurred after an average of 9.8 ± 2.6 months. The lordosis angle and lumbosacral angle were increased from preoperative 20.4 ± 2.9° and 14.7 ± 3.4°to postoperative 32.8 ± 3.6° and 22.4 ± 5.5°, with the angle loss of 1.0 ± 0.7° and 0.8 ± 0.7° at the final follow-up, respectively. No significant differences between preoperative and postoperative adjacent segment disc height (DH) were found. Conclusions one-stage posterior debridement, titanium mesh cage bone grafting and single-segment fixation can be an effective and feasible treatment option for mono-segmental lumbar and lumbosacral spinal tuberculosis in adults. It may preserve lumbar normal motor units and decrease adjacent segment degeneration (ASD) with the advantages of minimally invasion and rapid postoperative rehabilitation.

scholarly journals One-stage posterior debridement and single-segment interbody fusion for treating mono-segmental lumbar and lumbosacral spinal tuberculosis in adults following minimum 5-year follow-up

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Zhenchao Xu ◽  
Xiyang Wang ◽  
Zheng Liu
Keyword(s):  
Interbody Fusion ◽  
Spinal Tuberculosis ◽  
Adjacent Segment ◽  
Titanium Mesh ◽  
Titanium Mesh Cage ◽  
Single Segment ◽  
One Stage ◽  
Mesh Cage ◽  
Posterior Debridement

Abstract Background To evaluate the mid-long-term outcomes of surgical management of mono-segmental lumbar and lumbosacral spinal tuberculosis (TB) in adults by one-stage posterior debridement, single-segment fixation, and titanium mesh cage interbody fusion. Methods A total of 62 patients with mono-segmental lumbar or lumbosacral spinal tuberculosis were enrolled. One-stage posterior debridement, single-segment fixation, and titanium mesh cage interbody fusion was performed. Clinical and radiographic outcomes were compared and analyzed. Results All patients were followed-up for an average of 75.0 ± 11.5 months and completely cured at the final follow-up. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) returned to normal within three months postoperatively. Postoperative Japanese Orthopedic Association (JOA) score, visual analog scale (VAS) and Oswestry Disability index (ODI) were significantly improved compared with preoperative values. Bony fusion occurred after an average of 9.8 ± 2.6 months. The lordosis angle and lumbosacral angle were increased from preoperative 20.4 ± 2.9° and 14.7 ± 3.4° to postoperative 32.8 ± 3.6° and 22.4 ± 5.5°, with angle loss of 1.0 ± 0.7° and 0.8 ± 0.7° at the final follow-up, respectively. No significant differences between preoperative and postoperative adjacent segment disc height (DH) were found. Conclusions One-stage posterior debridement, single-segment fixation, and titanium mesh cage interbody fusion represent effective and feasible treatment option for mono-segmental lumbar and lumbosacral spinal tuberculosis in adults. This approach may preserve lumbar normal motor units and decrease adjacent segment degeneration (ASD) with the advantages of minimal invasiveness and rapid postoperative rehabilitation.

scholarly journals Nonstructural Versus Structural Bone Grafting for Interbody Fusion in the Treatment of Lumbar Tuberculosis by a Single Posterior Approach

2021 ◽  
Author(s):  
Zenghui Zhao ◽  
Jianxiao Li ◽  
Wei Luo ◽  
Yong Zhu ◽  
Xing Du ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Bone Grafting ◽  
Interbody Fusion ◽  
Spinal Tuberculosis ◽  
Pedicle Screws ◽  
Surgical Trauma ◽  
Single Segment ◽  
One Stage ◽  
Significant Difference ◽  
Posterior Debridement

Abstract Background Many types of bone grafting have been reported for successful use in the treatment of lumbar spinal tuberculosis. However, none-structural bone grafting has rarely been studied. This study was aimed to identify the clinical efficacy of nonstructural with structural bone graft for interbody fusion in the surgical treatment of single segment lumbar tuberculosis after one stage posterior debridement.Methods We retrospectively reviewed patients with nonstructural (n=27) and structural (n=22) bone grafting after single-stage posterior debridement and instrumentation for lumbar tuberculosis with at least 24 months of follow-up. Plain radiographs, magnetic resonance imaging, computed tomography scans, and health-related outcomes (e.g., Visual Analog Scale for back pain, the Oswestry Disability Index) were collected and analyzed before and after surgery. Results Both nonstructural and structural bone grafting were associated with significant improvements in the life quality parameters, the laboratory tests, and the Cobb angle of local kyphosis. A slight loss of Cobb angle correction was observed in two groups. Nonstructural bone grafting exhibited the advantages of less operation duration, blood loss and lower bone fusion rate compared with structural bone grafting. There were three complications in the nonstructural bone grafting and four complications in the structural bone grafting group, with no significant difference between two groups.Conclusions In conclusion, nonstructural bone grafting can achieve comparable interbody fusion to structural bone grafting but has less surgical trauma and simpler surgical procedure than structural bone grafting in the treatment of single segment lumbar tuberculosis after one stage posterior debridement and pedicle screws fixation.

scholarly journals The efficiency of the posterior-only approach using shaped titanium mesh cage for the surgical treatment of spine tuberculosis in children: A preliminary study

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901880668 ◽  
Author(s):  
Hongqi Zhang ◽  
Qiang Guo ◽  
Yunjia Wang ◽  
Chaofeng Guo ◽  
Mingxing Tang
Keyword(s):  
Surgical Treatment ◽  
Spinal Tuberculosis ◽  
Operating Time ◽  
Titanium Mesh ◽  
Kyphosis Angle ◽  
Spinal Segment ◽  
Titanium Mesh Cage ◽  
Mesh Cage ◽  
The Mean

Purpose: The study aimed to evaluate the efficiency of the posterior-only approach using shaped titanium mesh cage for surgical treatment of spinal tuberculosis (TB) in children. Methods: Between January 2011 and July 2013, 22 children with a single motion spinal segment involved, including 10 with thoracic, 4 with thoracolumbar, and 8 with lumbar, were enrolled in the study. The patients were treated by the posterior-only approach using the shaped titanium mesh cages. Their medical records and radiographs were retrospectively analyzed. Results: The mean operating time was 163 min (ranging from 120 min to 200 min). Blood loss was 210–550 ml with an average of 300 ml. The mean follow-up period was 41.1 months. At the final follow-up, all patients showed a solid bony fusion without the infection recurrence. The average bone fusion time was 6.2 months. The average correction of the local segment kyphosis angle was 6.9° (from 9.2° preoperative to 2.3° postoperative). Minimal loss in correction angle was noted in these patients at the final follow-up (only 1.5°). Changes in erythrocyte sedimentation rate, local segment kyphosis angle, and neurological status demonstrated a significant clinical improvement in all children at their last follow-up. Conclusion: Children with spinal TB of a single motion spinal segment involved can be successfully treated by the posterior-only approach using shaped titanium mesh cage. It is a minimally invasive, safe, and effective surgical procedure.

Nonstructural versus structural bone grafting in the treatment of lumbar spinal tuberculosis combined with single-stage posterior debridement and instrumentation: a retrospective cohort study

2020 ◽  
Author(s):  
Zenghui Zhao ◽  
Jianxiao Li ◽  
Qiqi Peng ◽  
Yong Zhu ◽  
Wei Luo ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Bone Grafting ◽  
Spinal Tuberculosis ◽  
Single Stage ◽  
Anterior Column ◽  
Bone Fusion ◽  
Anterior Column Support ◽  
Lumbar Spinal ◽  
Posterior Debridement

Abstract Background Many types of bone grafting have been reported for successful use in achieving anterior column support and bone fusion after one stage posterior debridement in the treatment of lumbar spinal tuberculosis. However, none-structural bone grafting has rarely been studied. This study was aimed to identify the feasibility of none-structural bone grafting from comparing the advantages and disadvantages with structural bone grafting in the treatment of lumbar spinal tuberculosis. Patients and methods We retrospectively reviewed patients with lumbar spinal tuberculosis who had undergone none-structural (n=27) and structural (n=22) bone grafting after single-stage posterior debridement and instrumentation with at least 24 months of follow-up. Plain radiographs, magnetic resonance imaging, and computed tomography scans, as well as health-related outcomes, including Visual Analog Scale for back pain, the Oswestry Disability Index were collated before surgery and at follow-up. Results Both none-structural and structural bone grafting were associated with significant improvements in quality of life parameters, the laboratory tests and the Cobb angle of local kyphosis. A slight loss of Cobb angle correction was in both two groups, without any associated complications. The operation duration and blood loss in none-structural bone grafting group was significantly less. The bone fusion rate was higher in structural bone grafting group. There were three complications in the none-structural bone grafting and four complications in the structural bone grafting group; the incidence of complications between the two groups was not significantly different. Conclusions Based on single-stage posterior debridement and pedicle screws fixation, none-structural bone grafting can achieve anterior column support with reducing surgical trauma, simplifying surgical procedure and decreasing intraoperative hemorrhage, but the lower rate of grafted bone fusion should be taken into consideration when choosing the aforementioned method. Key words Lumbar spinal tuberculous; Single-stage posterior debridement; Anterior column support; Bone fusion; None-structural bone grafting; Structural bone grafting

scholarly journals Results to 4-year follow-up of the treatment of the cervical stenosis by corpectomy, titanium mesh cage and anterior plate fixation

2017 ◽  
Vol 85 (5) ◽  
pp. 381-386
Author(s):  
Alejandro Antonio Reyes Sánchez ◽  
Luis Alberto Gameros Castañeda ◽  
Claudia Obil Chavarría ◽  
Armando Alpizar Aguirre ◽  
Barón Zárate Kalfópulos ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Cervical Stenosis ◽  
Titanium Mesh ◽  
Anterior Plate ◽  
Titanium Mesh Cage ◽  
Mesh Cage

scholarly journals Clinical Use of the Nanohydroxyapatite/Polyamide Mesh Cage in Anterior Cervical Corpectomy and Fusion Surgery

2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Hui Xu ◽  
Xiaofeng Ren ◽  
Dawei Wang ◽  
Yongfei Zhao ◽  
Yan Wang ◽  
...  
Keyword(s):  
Japanese Orthopaedic Association ◽  
Clinical Use ◽  
Titanium Mesh ◽  
Polyamide 66 ◽  
Titanium Mesh Cage ◽  
Cervical Corpectomy ◽  
Cage Subsidence ◽  
Mesh Cage ◽  
Anterior Cervical Corpectomy

Purpose. This study was to report the clinical use of biomimetic nanohydroxyapatite/polyamide 66 (n-HA/PA 66) mesh cages in anterior cervical corpectomy and fusion (ACCF) surgery.Method. 95 patients who underwent single level anterior cervical corpectomy and fusion for cervical spondylosis myelopathy (CSM) in our hospital were reviewed and divided into 2 groups according to using nanohydroxyapatite/polyamide mesh cage and titanium mesh cage (TMC). Demographic data of patients and surgical, clinical, and radiological data before operation and at last follow-up were collected and compared.Result. The operation time, surgical blood loss, complications, and Japanese Orthopaedic Association scores (JOA scores) of two groups were similar. At the last follow-up both the two groups obtained 100% solid bone fusion, but the TMC group had higher rate of severe cage subsidence than the n-HA/PA 66 group (27% versus 2%).Conclusion. Nanohydroxyapatite/polyamide 66 mesh cage is safe and effective in ACCF and can be a substitution to titanium mesh cage.

scholarly journals The efficacy of single posterior debridement, bone grafting, and instrumentation for the treatment of thoracic spinal tuberculosis

2020 ◽  
Author(s):  
Jiao Zhou ◽  
Quanyi Li ◽  
Yongchun Zhou ◽  
Qichun Song
Keyword(s):  
Bone Grafting ◽  
Spinal Tuberculosis ◽  
Clinical Manifestations ◽  
Adult Patients ◽  
Thoracic Spinal ◽  
Imaging Results ◽  
Single Posterior Approach ◽  
Posterior Debridement ◽  
Thoracic Spinal Tuberculosis

Abstract Background: The aim of this study was to investigate the clinical efficacy of single posterior debridement, bone grafting, and instrumentation for the treatment of thoracic spinal tuberculosis of adult patients. Methods: A retrospective analysis was conducted on 88 adult patients with thoracic spinal tuberculosis between June 2013 and September 2017. All patients were treated with single posterior debridement, bone grafting and instrumentation. The clinical manifestations and laboratory and imaging results of the approach were subsequently analysed. Results: All patients were followed up for 40.6 ± 4.1 m (range, 36–48 m). Bony fusion was achieved in all bone grafts. The VAS scores, ESR, and CRP levels 6 weeks after operation and at the final follow-up were significantly lower than the preoperative levels (P<0.05). The postoperative and final-follow-up kyphosis angles were both significantly smaller than the pre-operative kyphosis angles (P<0.05). The postoperative angle correction rate reached 81.5%, and the postoperative angle loss only reached 4.1%. At the last follow-up, ASIA improvement was significant compared with the preoperative levels (P<0.05). Conclusion: The single posterior approach can achieve satisfactory clinical outcomes in the treatment of thoracic spinal tuberculosis.

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