A comparison of three bone graft struts for interbody fusion using a posterior approach for lower lumbar spinal tuberculosis in adults: a midterm follow-up study

• Published in: BMC musculoskeletal disorders Vol. 23; no. 1; pp. 1 - 590
• Main Authors: Xu, Zhenchao, Wang, Xiyang, Zhang, Zhen, Jiang, Dingyu, Jia, Runze, Zhang, Yilu
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 18.06.2022; BioMed Central; BMC
• Subjects: Abscesses; Allogeneic bone graft Titanium mesh cage; Autogenous bone graft; Back pain; Bone grafts; Bone-grafting; Clinical medicine; Debridement; Degeneration; Lower lumbar spinal tuberculosis; Methods; Musculoskeletal diseases; Patient outcomes; Patients; Posterior approach; Quality of life; Scoliosis; Skin & tissue grafts; Spinal fusion; Spine; Surgery; Titanium; Tuberculosis; Vertebrae; China
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-022-05539-8

Abstract Background This retrospective observational study was conducted to compare midterm outcomes of three bone graft struts for interbody fusion using a posterior approach in adults with lower lumbar spinal tuberculosis. Methods A total of 126 lower lumbar spinal tuberculosis patients were treated by one-stage posterior debridement, interbody fusion, and instrumentation. Forty-one patients (group A) were treated with autogenous bone graft for interbody fusion, 45 patients (group B) were treated with allogeneic bone grafting, and the remaining 40 (group C) patients were treated with titanium mesh cage. In addition, clinical and radiographic data were gathered and analyzed. Results At the final follow-up, all patients were completely cured. The operation period and intraoperative blood loss for groups B and C were significantly less than in group A ( P  = 0.000). Post-operation, neurological performance and quality of life were remarkably improved at the final follow-up. The preoperative lordosis angles of three groups were significantly improved, as evidenced by the values immediately after the operation or those at the final follow-up. The correction loss of the group C was lower than those of groups A and B ( P  = 0.000). All the patients obtained bone graft fusion, the fusion period of group B was longer than that of the other two groups ( P  = 0.000). No significant differences among the three groups in adjacent segment degeneration rates were found at the last visit ( P  = 0.922). Conclusions This midterm follow-up study established that one-stage posterior debridement, interbody fusion, and instrumentation, combined with medical therapy, can effectively treat lower lumbar spinal tuberculosis. In addition, the intervertebral titanium mesh cage bone graft can provide better outcomes with regard to maintaining lordosis and preventing collapse.