[Lateral position one-stage combined posteroanterior approaches for the treatment of lumbosacral tuberculous spondylitis].

OBJECTIVE: To investigate the feasibility of a one-stage combined posteroanterior approaches for the treatment of lumbosacral tuberculous spondylitis with the patients lying in a lateral position. METHODS: A retrospective review was conducted for 15 patients with lumbosacral tuberculosis undergoing one-stage combined posteroanterior approaches for radical lesion resection and reconstruction. All patients were observed and evaluated by clinical and imaging studies. RESULTS: Operative posture:11 cases for right side and 4 cases for left side. The mean operative duration was 280 min (range: 230 - 380 min) and the mean estimated volume of blood loss 1720 ml (range: 1100 - 3000 ml). Imaging results: No recurrence of tuberculose focus was found until the last follow-up. Upon image reviewing, it showed no loosening or displacement except for two cases of slightly collapsed titanium mesh. Preoperative and postoperative changes in the degree of lumbar lordosis were statistically significant [(20 ± 5)° vs (31 ± 5)°, P < 0.05]. The Kirkaldy-Willis classification rating yielded satisfactory results for 13 cases. CONCLUSION: The patients with lumbosacral tuberculosis undergoing one-stage combined posteroanterior approaches may achieve radical lesion resection, posteroanterior collaboration and reconstruction. It avoids a 2-stage operation, eliminates the need of changing a patient's body position with secondary sterilization and shortens the operative duration. Lumbosacral surgery for tuberculosis combines the respective advantages of anterior, posterior and combined posteroanterior approaches and yet makes up for their deficiencies.