The efficacy of local continuous chemotherapy and postural drainage in combination with one-stage posterior surgery for the treatment of lumbar ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-02-09

AUTHORS

Yongchun Zhou, Zongrang Song, Jing Luo, Jijun Liu, Yunfei Huang, Yibin Meng, Wentao Wang, Dingjun Hao

ABSTRACT

BACKGROUND: The objective of this study was to compare the outcomes of one-stage posterior surgery involving debridement, bone grafting, and instrumentation with and without local continuous chemotherapy and postural drainage for the treatment of lumbar spinal tuberculosis. METHODS: From January 2009 to January 2013, 109 patients with lumbar spinal tuberculosis were treated in our center using a posterior surgical approach. Patients underwent one-stage posterior debridement, bone grafting, and instrumentation, without (group A) and with (group B) local continuous chemotherapy and postural drainage. Clinical and radiographic results for the two groups were analyzed and compared. Clinical efficacy was evaluated based on surgery duration and blood loss. The Frankel scale was used to evaluate neurological function. A visual analog scale was used to assess low back pain. Bone graft fusion and instrumentation failure were monitored by radiography, and tuberculosis activity was monitored by erythrocyte sedimentation rate (ESR) and C-reactive protein testing. RESULTS: Groups A and B contained 52 and 57 patients, respectively. Patients were followed for 18-36 (mean, 26.64 ± 4.2) months. All bone grafts ultimately fused, but the fusion rate was significantly more rapid in group B [6.4 ± 0.5 (range, 5-10) months] than in group A [8.9 ± 0.6 (range, 6-12) months; P < 0.05]. At 6 weeks postoperatively, ESR levels differed significantly between groups A and B (24.6 ± 1.5 vs. 16.3 ± 1.1 mm/h; P < 0.05). ESR levels normalized in both groups at 16 weeks. CONCLUSIONS: Local continuous chemotherapy and postural drainage effectively eliminated infection foci caused by abscess remnants and accelerated interbody bone fusion in patients with lumbar spinal tuberculosis undergoing one-stage posterior surgery involving debridement, bone grafting, and instrumentation. More... »

PAGES

66

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12891-016-0921-2

DOI

http://dx.doi.org/10.1186/s12891-016-0921-2

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1030773874

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26862044


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37 schema:description BACKGROUND: The objective of this study was to compare the outcomes of one-stage posterior surgery involving debridement, bone grafting, and instrumentation with and without local continuous chemotherapy and postural drainage for the treatment of lumbar spinal tuberculosis. METHODS: From January 2009 to January 2013, 109 patients with lumbar spinal tuberculosis were treated in our center using a posterior surgical approach. Patients underwent one-stage posterior debridement, bone grafting, and instrumentation, without (group A) and with (group B) local continuous chemotherapy and postural drainage. Clinical and radiographic results for the two groups were analyzed and compared. Clinical efficacy was evaluated based on surgery duration and blood loss. The Frankel scale was used to evaluate neurological function. A visual analog scale was used to assess low back pain. Bone graft fusion and instrumentation failure were monitored by radiography, and tuberculosis activity was monitored by erythrocyte sedimentation rate (ESR) and C-reactive protein testing. RESULTS: Groups A and B contained 52 and 57 patients, respectively. Patients were followed for 18-36 (mean, 26.64 ± 4.2) months. All bone grafts ultimately fused, but the fusion rate was significantly more rapid in group B [6.4 ± 0.5 (range, 5-10) months] than in group A [8.9 ± 0.6 (range, 6-12) months; P < 0.05]. At 6 weeks postoperatively, ESR levels differed significantly between groups A and B (24.6 ± 1.5 vs. 16.3 ± 1.1 mm/h; P < 0.05). ESR levels normalized in both groups at 16 weeks. CONCLUSIONS: Local continuous chemotherapy and postural drainage effectively eliminated infection foci caused by abscess remnants and accelerated interbody bone fusion in patients with lumbar spinal tuberculosis undergoing one-stage posterior surgery involving debridement, bone grafting, and instrumentation.
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44 schema:keywords ESR levels
45 Frankel scale
46 abscess remnants
47 activity
48 analog scale
49 approach
50 back pain
51 blood loss
52 bone fusion
53 bone graft
54 bone graft fusion
55 bone grafting
56 center
57 chemotherapy
58 clinical efficacy
59 combination
60 continuous chemotherapy
61 debridement
62 drainage
63 duration
64 efficacy
65 erythrocyte sedimentation rate
66 failure
67 focus
68 function
69 fusion
70 fusion rate
71 graft
72 graft fusion
73 grafting
74 group
75 group A
76 group B
77 infection foci
78 instrumentation
79 instrumentation failure
80 interbody bone fusion
81 levels
82 local continuous chemotherapy
83 loss
84 low back pain
85 lumbar spinal tuberculosis
86 months
87 neurological function
88 objective
89 one-stage posterior debridement
90 one-stage posterior surgery
91 outcomes
92 pain
93 patients
94 posterior debridement
95 posterior surgery
96 posterior surgical approach
97 postural drainage
98 protein testing
99 radiographic results
100 radiography
101 rate
102 reactive protein testing
103 remnants
104 results
105 scale
106 sedimentation rate
107 spinal tuberculosis
108 study
109 surgery
110 surgery duration
111 surgical approach
112 testing
113 treatment
114 tuberculosis
115 tuberculosis activity
116 visual analog scale
117 weeks
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