Pedicle subtraction osteotomy for the corrective surgery of ankylosing spondylitis with thoracolumbar kyphosis: experience with 38 patients.

OBJECTIVE: To evaluate the sagittal parameters and clinical outcome of pedicle subtraction osteotomy (PSO) for the treatment of ankylosing spondylitis (AS) combined with thoracolumbar kyphosis. METHODS: The clinical data of 38 patients with AS combined with thoracolumbar kyphosis who underwent PSO were enrolled and divided into the lumbar lordosis group and the lumbar kyphosis group according to the preoperative sagittal morphology. They were subdivided into the lumbar lordosis T12 group, lordosis L1 group, kyphosis L2 group, and kyphosis L3 group. The spine sagittal parameters were compared between the preoperative and the postoperative. Outcome evaluation was performed by the Japanese Orthopedic Association (JOA) score, visual analogue scale (VAS), and the Oswestry Disability Index (ODI). RESULTS: A total of 38 patients with AS combined with thoracolumbar kyphosis were successfully treated by PSO, with a mean follow-up time of 26.9 ± 11.9 months. There were 30 males and 8 females with a mean age of 41.6 ± 7.1 years. Twenty patients consisted in the lumbar lordosis group and 18 patients in the lumbar kyphosis group. GK, SVA, and CBVA were improved significantly (P < 0.05) at the final follow-up between the lumbar lordosis T12 group and the L1 group. Patients in the lumbar kyphosis L2 group and L3 group all received satisfactory, including LL, GK, and SVA (P < 0.05). There was no statistically significant difference in the preoperative TK, GK, SVA, PT, and PI between the lumbar lordosis and lumbar kyphosis groups (P > 0.05). Postoperative complications occurred in three cases. CONCLUSION: PSO was a practical method for the treatment of patients with AS combined with thoracolumbar kyphosis. PSO at L3 was recommended to be selected for the lumbar kyphosis to obtain greater SVA correction. CBVA of single-segment PSO may be significantly lower than the two-segment PSO in the management of patients with kyphosis of lower CBVA.

Efficacy of anterior debridement and bone grafting with fusion using internal fixation combined with anti-tuberculosis chemotherapy in the treatment of subaxial cervical tuberculosis.

BACKGROUND: To evaluate the efficacy of anterior debridement and bone grafting with fusion using internal fixation (BFIF) combined with anti-tuberculosis chemotherapy in the treatment of subaxial cervical spine tuberculosis (SCS-TB). METHODS: Clinical and radiographic data of patients with SCS-TB treated by anterior debridement and BFIF at our hospital from January 2010 to December 2017 were analyzed retrospectively. The SCS sagittal parameters at the preoperative, postoperative, and final follow-up were documented and compared, including the Occiput-C2 angle, C2-C7 Cobb angle, local Cobb angle, spinal canal angle (SCA), C2-C7 sagittal vertical axis (C2-C7 SVA), the center of gravity of the head-C7 sagittal vertical axis (CGH-C7 SVA), T1 slope (T1S), neck tilt (NT), and thoracic inlet angle (TIA). The ASIA grade, NDI index, JOA score, and VAS score were utilized to assess the postoperative function recovery, and the complications were recorded. RESULTS: A total of 23 patients were included in the study with a mean age of 46.74 ± 15.43 years, including 8 males and 15 females. All patients with SCS-TB were treated with anterior debridement and BFIF, with a mean postoperative follow-up time of 37.17 ± 12.26 months. The poisoning symptoms of TB were relieved in all patients, and ESR (42.09 ± 9.53 vs 8.04 ± 5.41, P < 0.05) and CRP (30.37 ± 16.02 vs 7.4 ± 2.68, P < 0.05) were decreased at the 3 postoperative months in the comparison of the preoperative. The C0-C2 Cobb angle, C2-C7 Cobb angle, local Cobb angle, SCA, TIS, C2-C7 SVA, and CGH-C7 SVA were corrected remarkably after surgery (P < 0.05). Further, there was a significant improvement in the JOA, VAS, and NDI with the comparison of the preoperative (P < 0.05). CONCLUSIONS: Anterior debridement and BFIF combined with anti-TB chemotherapy was a practical tool for the treatment of SCS-TB with the help of SCS sagittal parameters, which can remove the lesion completely, decompress the spinal cord compression, and correct the kyphotic deformity to restore the spine sagittal balance.

Multiple debridement of cavity lesions combined with antiparasitic chemotherapy in the treatment of mid or advanced spinal echinococcosis: a retrospective study of 33 patients.

OBJECTIVE: The purpose of this study was to evaluate and document the complications and outcomes (bone and functional) of multiple debridement of cavity lesions combined with antiparasitic chemotherapy in the treatment of mid or advanced spinal echinococcosis. METHODS: From January 2007 to February 2019, the medical records and imaging of all patients with mid or advanced spinal echinococcosis, who were treated by multiple debridement of cavity lesions, were evaluated retrospectively. The Braithwaite and Less classification system of spinal echinococcosis and the Frankel classification system were used to evaluate the results, both preoperatively and postoperatively. RESULTS: Between January 2007 and February 2019, 33 patients met the criteria and were included in this study, with a mean postoperative follow-up time of 4.9 (1-10) years. They included 18 males (54.5%) and 15 females (45.4%), with a mean age of 41.5 years (range 23-70 years). A satisfactory recovery of lower-limb motor function was found in 32 patients, while 24 patients (72.7%) presented with recurrence of spinal echinococcosis. CONCLUSIONS: Multiple debridement and spinal cord decompression, combined with antiparasitic chemotherapy after surgery, are effective methods for delaying or preventing disease progression or recurrence. A recurrence of infection is common in most cases. CT and MRI are the preferred methods for diagnosing this disease.

Long-term outcomes of posterior release and reduction for irreducible atlantoaxial dislocation / 中华骨科杂志

Objective:To evaluate the long-term outcomes of posterior release, reduction, fixation, and fusion for irreducible atlantoaxial dislocation (AAD).Methods:Between January 2005 and June 2016, a total of 31 patients with irreducible AAD who had received posterior approach surgery were included. Among them, there were 13 males and 18 females, the average age was 39.1±13.5 years (range 9-72 years). The clinical data of the eligible individuals were collected and analyzed. Neck disability index (NDI) and Japanese Orthopaedic Association (JOA) scores were recorded to evaluate the recovery of neck and neurological functions. The atlantodental interval (ADI), clivus-canal angle (CCA), and cervico-medullary angle (CMA) were measured to evaluate the reduction of AAD. C 0-C 2 angle and C 2-C 7 angle were measured to evaluate the recovery of cervical alignment. For individuals with basilar invagination, the distances from the tip of odontoid process to Chamberlain line and Wackenheim line were measured to assess the reduction in the vertical direction. The duration of bony fusion and complications were also analyzed. Results:The mean follow-up period was 82.7±26.4 months (range 61-170 months). In terms of functional scores, the NDI dropped from 43.41%±11.60% before surgery to 12.19%±6.97% at the six months follow-up, and 9.45%±7.51% at the last follow-up ( F=89.56, P<0.001). The JOA increased from 9.48±2.41 points before surgery to 14.71±1.42 points at the six months follow-up, and 14.97±1.47 points at the last follow-up ( F=52.89, P<0.001). Regarding the horizontal and vertical dislocations, the ADI decreased from 9.16±2.32 mm before surgery to 1.39±1.04 mm at the six months follow-up, and 1.29±1.08 mm at the last follow-up ( F=189.61, P<0.001). The distance from the tip of odontoid process to Chamberlain line decreased from 11.15±4.35 mm before surgery to 2.03±2.83 mm at the six months follow-up, and 2.15±3.02 mm at the last follow-up ( F=37.58, P<0.001). The distance from the tip of odontoid process to Wackenheim line reduced from 6.81±2.57 mm before surgery to -2.23±1.58 mm at the six months follow-up, and -2.27±1.58 mm at the last follow-up ( F=122.16, P<0.001). For the amelioration of the compression on medulla and spinal cord, the CCA increased from 113.68°±12.67° before surgery to 143.39°±7.38° at the six months follow-up, and 142.39°±7.13° at the last follow-up ( F=67.13, P<0.001). The CMA increased from 115.71°±13.69° before operation to 145.58°±10.78° at the last follow-up ( F=41.44, P<0.001). Regarding the curvature of the cervical spine, the C 0-C 2 angle recovered from 1.94°±15.82° before surgery to 14.84°±6.45° at the last follow-up ( F=11.97, P<0.001), and the C 2-C 7 angle ameliorated from 27.26°±8.49° before operation to 19.26°±5.44° at the last follow-up ( F=11.13, P<0.001). Bony fusion was achieved in all cases, the fusion time was 9.71±2.55 months (range 5-15 months). A total of five complications occurred in the cases (two cerebrospinal fluid leakages, one deep infection, one transient neurologic deficit, and one dysphagia). They were all cured with corresponding treatments. In the last follow-up, none of the cases developed failure of internal fixation or re-dislocation. Conclusion:Posterior approach release, reduction, fixation and fusion technique is a safe and efficient surgical strategy with favorable long-term follow-up outcomes for irreducible AAD.

Diagnosis and Surgical Treatment of Human Brucellar Spondylodiscitis.

Brucellar spondylodiscitis (BS) is the most prevalent and significant osteoarticular presentation of human Brucellosis, which is commonly manifested in pastoral communities. It is difficult to differentially diagnose and usually leads to irreversible neurologic deficits and spinal deformities. The initial diagnosis of BS is based on clinical findings and radiographic assessments, and the confirmed diagnosis should be established by the isolation of Brucella species from the blood and/or the standard tube agglutination test. Differential diagnosis of multifocal BS from either degenerative disc diseases or tuberculosis is especially highlighted. The surgical approach, either endoscopic or open, is demonstrated in detail, accompanied by radiographic evidence of structural compression or severe instability. Further, the crucial surgical steps, including single-stage transforaminal decompression, debridement, interbody fusion, and internal fixation, are explained. Moreover, perioperative care and postoperative rehabilitation are also addressed. Taken together, this clinical algorithm presents a practical guide that has yielded substantially satisfactory outcomes in the past decades, which can also be introduced for large-scale application to manage human BS, especially in endemic regions.

Comparison of the Clinical Efficacy of 3 Surgical Methods for Treating Spinal Tuberculosis in Children.

BACKGROUND This study aimed to investigate the safety and clinical efficacy of 3 different surgical methods for treating spinal tuberculosis (ST) in children. MATERIAL AND METHODS We reviewed the cases of 62 children with ST who were treated in our hospital from January 2010 to December 2014. In this study, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, Frankel classification of neurological function, pain visual analog scale (VAS) score, and kyphosis Cobb (k-Cobb) angle were dynamically monitored to evaluate the efficacy of different surgical methods. Complications in the patients were evaluated at 3 time points: before surgery (T1), after surgery (T2), and during final follow-up (T3). The average follow-up was 27.4 months. Twenty-two patients underwent simple anterior debridement alone or combined with internal fixation (Method A), 13 patients underwent posterior debridement alone (Method B), and 27 patients received anteroposterior debridement and bone graft fusion together with internal fixation (Method C). RESULTS In all 3 groups after surgery, ESR, CRP levels, VAS scores, and k-Cobb angles significantly decreased. However, compared with patients who received Methods B and C, patients who received Method A had a significant rebound in k-Cobb angle and a higher incidence of complications at the T3 time point. The overall reoperation rate during follow-up was 37.10%. Fourteen patients (22.58%) had kyphosis, 2 patients (3.23%) had tuberculosis recurrence combined with kyphosis, and other complications were reported in 5 patients (8.06%). CONCLUSIONS Considering the incidence of complications and level of postoperative biochemical indicators, we concluded that caution should be exercised in using an anterior approach to treat pediatric ST.

Surgical treatment of post-traumatic epiphyseolisthesis at odontoid process in children / 中华骨科杂志

Objective:To evaluated the indications, methods, outcomes and prognosis of surgical treatment for post-traumatic epiphyseolisthesis at odontoid process in children.Methods:Retrospective analysis was performed on 5 cases of children with delayed epiphyseolisthesis of odontoid process in our institution from July 2009 to October 2016, including 1 male and 4 females. Initial surgery age were at1.7~5.4 years old, averaged (39.6±19.4) months and were 0.67-8 months, averaged (87.0±95.1) days. Disease duration ranged from 23 days to 8 months, with an average of 88 days. X-ray, CT and MRI examinations of the occipital-cervical area were taken to evaluate the type of the fracture and the severity of spinal cord compression. Children were treated with anterior loosening combined with posterior fixation fusion or posterior loosening reduction and internal fixation respectively.The function of spinal cord was evaluated by Frankel scale at pre- and post- operation. During the follow-up, X-ray and CT were performed to assess the fusion condition of the grafted bone.Results:The duration of operation was ranged from 75-145 months, with an average of (101.0±20.7) months; Blood loss ranged from 50-100 ml, with an average of (70.0±21.2) ml; follow-up duration ranged from 6 to 48 months, with an average of (23.5±17.6) months. Two cases preoperatively evaluated as Frankel C and D recovered to postoperative Frankel E. Among the five cases, two received satisfactory reduction, two cases received incomplete reduction, and one experienced failure reduction. The epiphyseolisthesis and bone grafted sites achieved solid fusion at 6-15 months after surgery, with an average of (9.5±3.4) months. The physiological curvature of cervical remained well without bone resorption, nonunion, pseudoarthrosis, as well as screw loosening or broken. Internal fixation of 2 cases were removed.Conclusion:Children with post-traumatic epiphyseolisthesis at odontoid process are not common in clinical practice. The detailed diagnosis of medical history, physical examination and comprehensive imaging evaluation. The posterior approach technique of C1-2 was feasible and effective, which could obtain decompression, reconstruction andstability all together.

Establishment and Initial Testing of a Medium-Sized, Surgically Feasible Animal Model for Brucellar Spondylodiscitis: A Preliminary Study.

Brucellar spondylodiscitis, the most prevalent and significant osteoarticular presentation of human Brucellosis, is difficult to diagnose and usually yields irreversible neurologic deficits and spinal deformities. However, no animal models of Brucellar spondylodiscitis exist, allowing for preclinical investigations. The present study investigated whether intraosseous injection of attenuated Brucella melitensis vaccine into rabbits' lumbar vertebrae imitates the radiographic and histopathological characteristics of human Brucellar spondylodiscitis. Radiographic and histopathological analyses at 8 weeks postoperatively revealed radiographic changes within vertebral bodies and intervertebral discs, abscesses formation within the paravertebral soft tissue, and typical prominent inflammation response without caseous necrosis, which were largely comparable to human Brucellar spondylodiscitis. Such a medium-sized, surgically feasible rabbit model provides a promising in vivo setting for further preclinical investigation of Brucellar spondylodiscitis.

Anatomical and radiologic characteristics of isthmus parameters in guiding pedicle screw placement.

Objective To study the clinical application of lumbar isthmus parameters in guiding pedicle screw placement. Methods Lumbar isthmus parameters were measured in normal lumbar x-rays and cadaveric specimens from a Chinese Han population. Distance between the medial pedicle border and lateral isthmus border was recorded as a 'D' value and was compared between X-rays and cadavers. Orthopaedic surgeons estimated different distances (2-6 mm) and angles (5-20°), and bias ratios between estimated and real values were compared. Orthopaedic residents placed pedicle screws on cadaveric specimens before and after application of the 'D' value, and screw placement accuracy was compared. Results Except for L4 vertebrae, significant differences in the 'D' value were found between 25 cadaveric specimens and x-ray films from 120 patients. Distances and angles estimated by 40 surgeons were significantly different from all real values, except 2 mm distance. Accuracy of pedicle screw placement by six orthopaedic residents was significantly improved by applying the 'D' value. Conclusions Surgeon estimates of distance were more accurate than angle estimates. Addition of a 'D' value to conventional parameters may significantly improve pedicle screw placement accuracy in lumbar spine surgery.

Smith-Petersen osteotomy combined with anterior debridement and allografting for active thoracic and lumbar spinal tuberculosis with kyphotic deformity in young children: A prospective study and literature review.

The purpose of this study is to determine the efficacy and safety of Smith-Petersen osteotomy combined with anterior debridement and allogenic strut bone grafting for the treatment of active thoracic and lumbar spinal tuberculosis with kyphotic deformity in young children.Spinal tuberculosis is more destructive in young children and often causes severe kyphosis and paraplegia. Despite much progress has been made, surgical treatment is still controversial and technically challenging.From October 2010 to August 2014, 25 children (11 males, 14 females; aged under 6 years) with active thoracic and lumbar spinal tuberculosis treated by Smith-Petersen osteotomy combined with anterior debridement and allogenic strut bone grafting were enrolled in this study. The pre- and postoperative data, follow-up medical records, imaging studies, and laboratory data were collected prospectively. Clinical outcomes were evaluated on the basis of kyphotic angle and the Frankel motor score system. The changes in C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), clinical symptoms, and complications were investigated. Graft fusion was evaluated using the Bridwell grading criteria.The mean age was 3.5 ±â€Š1.76 years (range, 1-6 years). All patients were followed up for 25 to 45 months (average, 34.3 ±â€Š5.86 months). The average kyphotic angle was changed significantly from a preoperative value of 44.1 ±â€Š10.8° to a postoperative value of 11.4 ±â€Š3.9°, with an average correction rate of 74% (P < .05). According to the Frankle motor score system, neurological deficits were significantly improved by the time of the last follow-up, with an average improvement of 1.7 grades (P < .05). There were 2 cases of rod breakage and 1 case of graft bone displacement. No patients experienced a recurrence of tuberculosis. According to Bridwell criteria, the degree of fusion was grade I in 23 patients and grade II in 2 patients with a fusion rate of 92%.For young children with active thoracic and lumbar spinal tuberculosis, Smith-Petersen osteotomy combined with anterior debridement and allogenic strut bone grafting is a safe and simple procedure to achieve sufficient kyphosis correction, good neurological recovery, and reliable anterior column reconstruction.

Single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral brucellosis.

BACKGROUND: Spinal brucellosis is a less commonly reported infectious spinal pathology. There are few reports regarding the surgical treatment of spinal brucellosis in existing literature. This retrospective study was conducted to determine the effectiveness of single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation for lumbosacral spinal brucellosis. METHODS: From February 2012 to April 2015, 32 consecutive patients (19 males and 13 females, mean age 53.7 ± 8.7) with lumbosacral brucellosis treated by transforaminal decompression, debridement, interbody fusion, and posterior instrumentation were enrolled. Medical records, imaging studies, laboratory data were collected and summarized. Surgical outcomes were evaluated based on visual analogue scale (VAS), Oswestry Disability Index (ODI) and Japanese Orthopaedic Association (JOA) scale. The changes in C-reactive protein (CRP) levels, erythrocyte sedimentation rate (ESR), clinical symptoms and complications were investigated. Graft fusion was evaluated using Bridwell grading criteria. RESULTS: The mean follow-up period was 24.9 ± 8.2 months. Back pain and radiating leg pain was relieved significantly in all patients after operation. No implant failures were observed in any patients. Wound infection was observed in two patients and sinus formation was observed in one patient. Solid bony fusion was achieved in 30 patients and the fusion rate was 93.8%. The levels of ESR and CRP were returned to normal by the end of three months' follow-up. VAS and ODI scores were significantly improved (P < 0.05). According to JOA score, surgical improvement was excellent in 22 cases (68.8%), good in 9 cases (28.1%), moderate in 1 case (3.1%) at the last follow-up. CONCLUSIONS: Single-stage transforaminal decompression, debridement, interbody fusion, and posterior instrumentation is an effective and safe approach for lumbosacral brucellosis.

[Selection of indications and surgical treatment of basilar invagination with atlantoaxial dislocation].

OBJECTIVE: To evaluate the indications and effect of surgical treatment of basilar invagination (BI) with atlantoaxial dislocation (AAD) on the basis of retrospective analysis of the clinical and imaging data of patients. METHODS: Consecutive 21 patients with BI and AAD were surgically treated in Department of Spinal Surgery, The First Affiliated Hospital of Xinjiang Medical University from July 2000 to December 2013. There were 10 males and 11 females, aged from 7 to 59 years, with a mean of 36.4 years. The clinical symptoms and signs was recorded, and preoperative imaging examination including anteroposterior, lateral, dynamic films, MRI, CT and 3-dimensional reconstruction views of cervical spine were performed to identify the series. All cases were treated with operation. Neurological function was assessed by JOA scale and NDI score before, after surgery and at final follow-up. The postoperative X-rays, MRI or CT was taken to observed the results of decompression, fixation and fusion. RESULTS: There were 5 cases operated by posterior approach, combined anterior and posterior approach in 16 cases, atlantoaxial fixation in 2 cases, occipitocervical fixation in 19 cases. The average operation time was 200 mins, blood loss was 230 ml. Except for 2 death cases, 19 cases were followed up, the followed-up was arranged from 13 to 42 months, with an average of 21.6 months. Compared with preoperative parameters (7.8±1.3), the postoperative scores of JOA decreased significantly (14.1±0.5) and at the final follow-up (16.2±0.7) (P<0.05); compared with preoperative parameters (65.7±11.2), the postoperative scores of NDI decreased significantly (28.2±9.6) and at the final follow-up (22.7±7.4) (P<0.05) and no significant difference in JOA or NDI score existed between post-operation and last follow-up (P>0.05). The perioperative complications was discovered in 6 cases, including infection in 2 cases, cerebrospinal fluid (CSF) leakage in 2 cases, respiratory dysfunction, cleft palate in 1 case, respectively. CONCLUSION: BI with AAD can be treated by anterior, posterior or combined approaches. Careful evaluation, proper selection of indications and prevention of perioperative complications are important consideration to ensure the success of surgery.

Comparative study of proliferative and neurosphere differentiation capacities of adipose-derived mesenchymal stem cells at different passages / 中国组织工程研究

BACKGROUND:Adipose-derived mesenchymal stem cels are a group of pluripotent stem cels, and under certain conditions can differentiate into neural stem celsin vitro. OBJECTIVE:To investigate the proliferative and differentiation ability of different passage mesenchymal stem cellfrom adipose tissue into neurospheres. METHODS:The adipose-derived mesenchymal stem cels from Sprague-Dawley rats were separated and culturedin vitro, and morphology and proliferation rate of cels were observed and compared respectively at passages 3, 6, 10 and 20. The cellsurface antigens and cels cycle were identified by flow cytometry. Furthermore, adipose-derived mesenchymal stem cels were induced into neurospheres, and the neurosphere rate was counted. RESULTS AND CONCLUSION: Adipose-derived mesenchymal stem cels were mainly in long spindle shape, and cels at different passages had highly proliferative capacity in vitro. Except passage 3, adipose-derived mesenchymal stem cels strongly expressed CD29, CD44, CD73 and lowly expressed CD45 and CD34. The proportion of G0/G1 phase in cellcycle was 93.4% at passage 3, 92.7% at passage 6, 92.4% at passage 10, 86.0% at passage 20. Adipose-derived mesenchymal stem cels at passages 6 and 10 were easier to differentiate into neurospheres than those at passage 20 (P < 0.05), but cels at passage 3 were difficult to differentiate into neurospheres. Therefore, when using adipose-derived mesenchymal stem cels as seed cels, we should pay attention to choose the appropriate amplification passage in order to obtain the cels with best differentiation potential and cellpurity.

Debridement and interbody fusion by a single posterior approach for the treatment of lumbosacral regional spinal tuberculosis / 中华骨科杂志

Objective To evaluate the clinical effects of a single posterior translaminal or transforaminal debridement and internal fixation with bone graft for the treatment of lumbosacral regional spinal tuberculosis. Methods From January 2004 to October 2009, 32 patients with lumbosacral regional spinal tuberculosis were treated by a single posterior debridement and internal fixation with bone graft, including 21 males and 11 females with the mean age of 46 years (range, 32-65). The lesions located: 3 in L3,4, 19 in L4,5, 10 in L5S1. 20 cases were pedormed operation via translaminal approach, 12 via transforaminal approach. The modified Prolo scale, visual analogue scale (VAS), kyphosis angle and the vertebral body loss were measured before and after surgery, and in the final follow-up. Results All the patients were followed up for average 16 months (range, 12-24). The pre-, postoperative and final follow-up mean kyphosis angle were -24.3°,-34.8°, and -32.4° in the translaminal group, -25.4°, -35.2°, and 33.6° in the transforaminal group,respectively. According to the modified Prolo scale, the excellent and good result was 93.8%. VAS decreased significantly from 7.6 points to 2.9 after surgery. Conclusion Debridement and internal fixation with bone graft via a single posterior approach for the treatment of lumbosacral regional spinal tuberculosis was an easy and effective technique. The appropriate selection of indications, careful imaging evaluation and thorough surgical debridement played an important role in the treatment of lumbosacral regional spinal tuberculosis.