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The pre-operative CTA demonstrates the level of the bifurcation of iliac vessels is suitable for internal fixation.
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Abstract A combined anterior and posterior (AP) surgical approach is a popular treatment modality of lumbosacral tuberculosis, but it is often traumatic and complicated. The present study aims to find whether the anterior only approach with the ARCH plate system is less invasive than the AP approach in treating lumbosacral tuberculosis. The ARCH pl...
Citations
... In this study, we chose to combine posterior column osteotomy, cantilever beam technique, and traction orthopedics with anterior bone grafting and fusion surgery because of good spinal exibility, traction effects, and a cumulative number of damaged segments, which made it di cult to achieve complete lesion removal and adequate bulk support bone grafting through the posterior approach. The advantages of this surgical approach include complete lesion removal, adequate bone graft support [34], preserved integrity of the posterior longitudinal ligament, reduced resection problems in the normal posterior structures, prolonged surgery time because of arterial rupture bleeding in the posterior segment [35], reduced risk of spinal cord injury, delayed healing because of displacement, and ruptured support during correction of severe kyphosis [36]. Its surgery time, intraoperative bleeding, and complication rates were signi cantly lower compared to previously reported literature [31,33]. ...
Background: Intractable spinal tuberculosis is extremely uncommon, its treatment is challenging and still controversial. We aimed to investigate the efficacy of posterior and combined posterior-anterior surgical approaches for intractable tuberculous thoracolumbar kyphosis.
Methods: We retrospectively analyzed 63 cases of intractable tuberculous thoracolumbar kyphosis.The cases were divided into Group P and PA, the P group was treated with posterior surgery alone, and the PA group was treated with the combined posterior-anterior surgery. The surgical efficacy was evaluated based on the clinical symptoms, Kyphotic angle correction rate, Sagittal Vertebral Axis (SVA), operative time, intraoperative bleeding, and surgical complications. Symptoms and function were assessed using the American Spinal Injury Association (ASIA) spinal cord injury classification, the visual analogue scale (VAS), the Oswestry dysfunction index (ODI), and the Kirkaldy-Willis functional score. The degree of implant fusion was evaluated according to the Eck fusion grading scale.
Results: The preoperative Kyphotic angles were 59.4°±12.6° and 102.9°±16.6°, and the improved postoperative Kyphotic angles were 19.9°±6.2° and 28.5°±9.6° for the P and PA groups, with correction rates of 65.5%±12.0% and 72.0%±9.5%, respectively. The Kyphotic angle losses were 3.1°±1.4° and 4.2°±1.7° at the last follow-up for the P and PA groups, respectively. The preoperative SVA were 27.6±10.7 mm and 39.1±18.6 mm, which postoperatively improved to 20.6±9.0 mm and 26.4±12.1 mm in the P and PA groups, respectively. All patients had an ASIA classification of E, except two patients in the PA group with a classification of D at the time of the final follow-up. All patients with bone grafting achieved grade I fusion. The Kirkaldy-Willis functional scores were 89.7% and 85.3% for the p and PA groups, respectively, except for two case (1P and 1 PA group)with broken rods. no tuberculosis recurrence, internal fixation loosening, breakage, and obvious loss of correction were found during the follow-up period.
Conclusions: Simple posterior surgery can achieve the desired clinical outcomes in patients with mild Intractable Tuberculous thoracolumbar kyphosis. However, in severe patients with accumulated multiple segments, combined posterior-anterior surgery is required for satisfactory deformity correction, complete lesion removal, and significant bone grafting support, making it a safe and reliable treatment method.
... Na et al. stated that both the anterior and posterior approaches effectively achieve remission of LBS, yet the posterior approach offers superior correction of kyphotic deformity, reduced surgical invasiveness, and decreased incidence of complications 30 . Anterior debridement and bone graft fusion combined with posterior internal fixation are the common surgical methods for lumbar spondylitis 31,32 . However, this combination surgical method for LBS treatment has rarely been reported or compared with the other two common approaches. ...
This retrospective study aimed to compare the clinical efficacy of the posterior procedure with the combined anterior and posterior procedure in the surgical management of lumbar Brucella spondylitis. From January 2015 to June 2020, a total of 62 patients presenting with lumbar Brucella spondylitis underwent either one-stage posterior pedicle fixation, debridement, and interbody fusion (Group A, n = 33) or anterior debridement, bone grafting, and posterior instrumentation (Group B, n = 29). All patients were followed up for an average of 25.4 ± 1.5 months and achieved complete resolution of lumbar Brucella spondylitis. No significant differences between the groups were observed in terms of age or pre-operative, three-month postoperative and final follow-up indices of the VAS, ESR, CRP, lordosis angle, ODI scores, fusion time, and time of serum agglutination test conversion to negative (P > 0.05). Each patient exhibited notable improvements in neurological function, as assessed by the JOA score rating system. Group A demonstrated significantly shorter operative duration, intraoperative blood loss, and hospital stay compared to Group B (P < 0.05). Superficial wound infection was observed in one case in Group A, whereas Group B experienced one case each of intraoperative peritoneal rupture, postoperative ileus, iliac vein injury, and superficial wound infection. This study supports the efficacy of both surgical interventions in the treatment of lumbar Brucella spondylitis, with satisfactory outcomes. However, the posterior approach demonstrated advantages, including reduced surgical time, diminished blood loss, shorter hospital stays, and fewer perioperative complications. Consequently, the one-stage posterior pedicle fixation, debridement, and interbody fusion represent a superior treatment option.
... Different from traditional combined surgery with a large oblique incision resulting in enhanced risk of vascular, visceral, and neurological morbidities [14,15], M-OLIF technique accessed retroperitoneal space via a small incision which barely accommodated an adjustable retractor system. Meanwhile, abdominal muscular complex was bluntly dissected along muscle orientation via fingers rather than sharp dividing by electrotome, significantly limiting intraoperative bleeding in exposure. ...
Purpose
To advance a modified oblique lumbar interbody fusion (M-OLIF) achieving anterior debridement and posterior freehand instrumentation simultaneously in circumferential approach via dynamic position and compare with traditional combined anterior–posterior surgery (CAPS) in clinical and radiological evaluation.
Patients and methods
Innovative freehand instrumentation in floating position was described. Consecutive patients having undergone surgeries for lumbar tuberculosis from 2017 January to 2019 December had been retrospectively reviewed. Patients with follow-ups for at least 36 months were included and divided into M-OLIF or CAPS group according to surgical methods applied. Outcomes included operation time, estimated blood loss, complication profile for safety evaluation; Vascular Analogue Scale (VAS) and Oswestry Disability Index (ODI) for efficacy evaluation; C-reactive protein and Erythrocyte Sedimentation Rate for tuberculosis activity and recurrence evaluation; X-ray and CT scan for radiological evaluation.
Results
Totally 56 patients had been enrolled in the study (26 for M-OLIF and 30 for CAPS). Compared with CAPS group, M-OLIF group illustrated significantly decreased estimated blood loss, operation time, hospital stay, and less postoperative morbidities. Meanwhile, M-OLIF group showed earlier improvement in VAS in 3 days and ODI in the first month postoperatively, without obvious discrepancy in further follow-ups. The overall screw accuracy in M-OLIF and CAPS group was 93.8% and 92.3% respectively, without significant difference in perforation distribution.
Conclusion
M-OLIF was efficient for lumbar tuberculosis requiring multilevel fixation, with reduced operation time and iatrogenic trauma, earlier clinical improvement compared with traditional combined surgery.
... For the anterior approach, some surgeons have reported that they could obtain similar short-and mid-term outcomes with less trauma compared to the combined anterior and posterior approach. 12,13 However, there is still a concern that the internal fixation strength provided by the anterior approach might be inferior to that of the posterior and combined anterior-posterior approaches. ...
... Both anterior and combined anterior and posterior approaches have been used widely to achieve adequate lesion debridement. 13,[17][18][19][20] Previous studies have reported that the anterior approach with screw-plate infixation could achieve satisfactory short-or mid-term outcomes, which was similar to the combined anterior and posterior approach. In the present study, we first showed the safety and efficacy of the anterior one screw fixation approach in patients with LSTB. ...
... 21 In previous studies, surgeons have relied on rigid internal fixation, such as a screw-plate or dual screw-rod for restoring segmental stability and maintaining lumbosacral curvature. 13,[17][18][19][20]22 Moreover, they considered that a reliable fixation device is an important factor for achieving satisfactory outcomes when implementing the anterior approach in this region. However, performing internal fixation is difficult because of the complex anterior anatomy, which includes nerves, ureters, and major blood vessels. ...
Objective:
Both anterior and combined anterior and posterior approaches have been used to treat lumbosacral tuberculosis. However, long-term follow-up studies of each approach have not been conducted. We aimed to compare the long-term clinical and radiographical outcomes between the two approaches.
Methods:
In this retrospective cohort study, we included 49 patients with a minimum 6-year follow-up between January 2008 and March 2012. Twenty-four patients underwent the anterior approach (anterior group), and 25 underwent the combined anterior and posterior approach (anterior-posterior group). Student's t test, Mann-Whitney U test, and Pearson's chi-square test were used to compare the two groups regarding clinical data, such as visual analogue scale scores, Oswestry disability index scores and neurological status, and radiographical data, such as lumbosacral angle, lumbar lordosis, and L5-S1 height. Furthermore, operative time, length of stay, and intraoperative and postoperative blood loss (IBL, PBL) were recorded.
Results:
Both groups had satisfactory clinical and radiographical outcomes until the final follow-up. All patients achieved bony fusion, and no group differences were found in any of the clinical indices. Both groups corrected and maintained the lumbosacral angle, lumbar lordosis, and L5-S1 height. However, the operative time, length of stay, maximum Hb drop, IBL, and PBL of the anterior group (140.63 ± 24.73 min, 12.58 ± 2.45 days, 28.33 ± 9.70 g/L, 257.08 ± 110.47 ml, and 430.60 ± 158.27 ml, respectively) were significantly lower than those of the anterior-posterior group (423.60 ± 82.81 min, P < 0.001; 21.32 ± 3.40 days, P < 0.001; 38.48 ± 8.03 g/L, P < 0.001; 571.60 ± 111.04 ml, P < 0.001; and 907.01 ± 231.99 ml, P < 0.001).
Conclusion:
This retrospective study demonstrated long-term efficacy of the anterior approach with a single screw fixation, which was as effective as that of the combined anterior and posterior approach, with the advantage of less trauma.
... The L5-S1 spinal segment receives a high degree of biomechanical stress by transferring loads from the vertebral column to the pelvis and legs; thus, the stability of this segment is crucial [22,[25][26][27][28][29]. Nonetheless, TB involvement of the lumbosacral junction (i.e., lumbosacral TB) can lead to severe destruction of the L5 and S1 vertebral bodies along with the intervening intervertebral discall which lead to spinal instability [21,22,28,30]. Diagnosing TB in an osteoarchaeological series is challenging, but it is one of the few major human bacterial infections that is well-known in the palaeopathological record [31][32][33]. ...
The macromorphological examination of identified human osteological collections from the pre-antibiotic era (e.g., Terry Collection) can provide invaluable information about the skeletal manifestations of tuberculosis (TB) in individuals who did not receive pharmaceutical therapy. With analysis of such collections, new diagnostic criteria for TB can be recognised which can be used in palaeopathological interpretation. The aim of our paper is to provide a reference and aid for the identification of TB in past populations by demonstrating and discussing in detail the vertebral alterations indicative of one of its rare skeletal manifestations, lumbosacral TB. These changes were detected in two individuals from the Terry Collection (Terry No. 760 and Terry No. 1093). These two case studies furnish palaeopathologists with a stronger basis for diagnosing lumbosacral TB in skeletons which exhibit similar vertebral lesions from osteoarchaeological series. To illustrate this, an archaeological case from Hungary (KK146) is also presented, displaying vertebral alterations resembling that of the two cases from the Terry Collection. Through the demonstrated case studies, we can derive a better insight into the disease experience of people who lived in the past and suffered from TB.
... All the 15 patients with lumbosacral tuberculous spondylitis in this study underwent single-stage anterior and posterior approach surgery in lateral position. The procedures include radical focal debridement [27], anterior placement of titanium mesh containing bone graft, and posterior stabilization using pedicle fixation system [28]. The clinical outcomes for 13 cases were satisfactory. ...
Background
The local anatomy of the lumbosacral region of spine is complicated, with special biomechanical characteristics. For surgical management of tuberculous spondylitis reported in the literature, the methods would be two-stage anterior and posterior approaches or one-stage anterior and posterior approach with patient’s intraoperative position being changed. These types of surgery approaches would result in long operative duration and more intraoperative blood loss, and most important there is no coordination between anterior and posterior procedures.
Methods
The purpose of this study was to introduce a new procedure called in the lateral position single -stage combined anteriorposterior approaches for treatment of lumbosacral tuberculous spondylitis and to evaluate its preliminary surgical outcomes. Fifteen patients with lumbosacral tuberculous spondylitis who underwent single-stage anterior and posterior radical focal debridement and reconstruction in lateral position in our hospital from April 2005 to June 2012 were included in the study. There were 6 males and 9 females with the average age of 46.8 years. The tuberculous lesions involved the following regions: L3-4 in 5cases, L4-5 in 5 cases, L5-S1 in 2 cases, L4 in one case, and L5 in 2 cases. The assessment of surgical outcomes was conducted with clinical symptoms and radiological findings,including operative time, blood loss. deformity angle, Frankel grade and Kirkaldy-Willis evaluation.
Results
Operation posture: The right lateral position was used for 11 patients and the left lateral position was used for the remaining 4 patients. The average duration of operation for the 15 patients was 270 min. The average intraoperative blood loss was 1720 ml. The mean follow-up period was 4.2 years. There was no recurrence. The postoperative radiological findings showed that the interbody bone grafts were fixed without any dislodgment. There was significant difference between preoperative and postoperative lumbosacral lordotic angles. Kirkaldy-Willis classification rating for the 13 cases with satisfactory results.
Conclusion
Single-stage combined anterior and posterior surgical management of lumbosacral tuberculous spondylitis with patient in lateral position can achieve radical focal debridement, anterior and posterior procedure coordination and spinal reconstruction.
... Moreover, some surgeons have reported that outcomes similar to the combined anterior and posterior approach can be achieved with the anterior only approach (11,12). It is worth noting that the internal xation device used in both studies was the screw-plate system, and that both studies had relatively small sample sizes and short follow-up periods. ...
... Treatment is often associated with a large abscess in the presacral region, as well as destruction of the anterior vertebral columns. Both anterior only and combined anterior and posterior approaches have been used widely to achieve adequate lesion debridement and avoid draining the lesion into posterior areas (12,(15)(16)(17)(18). At the 25-month follow up of 13 patients with LSTB who underwent the anterior approach, He et al. (15) concluded that the anterior approach was as effective as the combined anterior and posterior approach. ...
... indicated satisfactory e cacy of the anterior approach at 40-month follow-up (12). However, their results were based on a relatively small sample size and a short follow up period. ...
Background: Both the anterior and combined anterior and posterior approaches have been used to treat lumbosacral tuberculosis. However, long-term follow-up studies of each approach have not been conducted. We aimed to compare the long-term clinical and radiographical outcomes between the two approaches.
Methods: We included 49 patients with a minimum 6-year follow up between January 2008 to March 2012. Twenty-four patients underwent the anterior approach (group A) and 25 underwent the combined anterior and posterior approach (group B). We collected clinical data, such as visual analogue scale scores, Oswestry disability index scores and neurological status, and radiographical data, such as lumbosacral angle and lumbar lordosis. Furthermore, operative time, length of stay, and intraoperative and postoperative blood loss (IBL, PBL) were recorded.
Results: Both groups had satisfactory clinical and radiographical outcomes until follow up. All patients achieved bony fusion, and no group differences were found in any of the clinical indices. Both groups corrected and maintained lumbosacral angle and lumbar lordosis. However, operative time, length of stay, maximum Hb drop, IBL, and PBL of group A (140.63 ± 24.73 min, 12.58 ± 2.45 d, 28.33 ± 9.70 g/L, 257.08 ± 110.47 mL, and 430.60 ± 158.27 mL, respectively) was significantly lower than those of group B (423.60 ± 82.81 min, p < 0.001; 21.32 ± 3.40 d, p < 0.001; 38.48 ± 8.03 g/L, p < 0.001; 571.60 ± 111.04 mL, p < 0.001; and 907.01 ± 231.99 mL, p < 0.001).
Conclusions: This retrospective study demonstrated long-term efficacy of the anterior approach, which was as effective as that of the combined anterior and posterior approach, with the advantage of less trauma.
... The adjacent organs in the lumbosacral area not only need to be protected from damage, but one also needs to pay special attention to the reconstruction of lumbosacral stability after lesion removal 8 . Thus far, various surgical methods including an anterior approach, a combined anteroposterior approach and a posterior approach have been described for treating lumbosacral junction TB [9][10][11] . Albeit direct exposure of the lesion and removal of the damaged vertebrae and disc have the above advantages, the anterior approach is still too invasive and involves abdominal organs and iliac vessels as described by some scholars. ...
Objective
To evaluate the medium‐term outcomes of one‐stage posterior lumbosacral or lumbopelvic fixation treatment of lumbosacral junction tuberculosis in adults.
Methods
This retrospective study enrolled a total of 38 adult patients (24 males and 14 females) with an average age of 48.0 ± 13.0 years (range, 25–75 years) during the period from February 2008 to July 2015. All patients were treated by one‐stage posterior debridement, interbody fusion, lumbosacral or lumbopelvic fixation, and postural drainage. After pedicle screw or iliac screw fixation, a hemi‐laminectomy or laminectomy was performed on the severely damaged side of the lesion segment. Intervertebral bone grafting and intertransverse bone grafting were performed after clearing the focus of tuberculosis. All cases were followed up for at least 5 years. Intraoperative blood loss, operative time, erythrocyte sedimentation rate (ESR), pain intensity was assessed by visual analog scale (VAS) score; neurological function was assessed by Japanese Orthopaedic Association (JOA) score; quality of life was assessed by Oswestry Disability Index (ODI); functional outcome, lumbosacral angle, and fusion time were gathered and analyzed. All data expressed as mean ± standard deviation.
Results
During the 66.2 ± 4.4 months (range, 60–78 months) follow‐up, all patients achieved clinical cure without severe complications. The intraoperative blood loss was 726.3 ± 151.9 mL (range, 400–1100 mL) and the operative time was 137.6 ± 22.5 min (range, 110–200 min). The ESR decreased to normal levels within (11.8 ± 2.6 mm/h) 3 months postoperatively. The VAS score significantly decreased from 6.8 ± 1.1 preoperatively to 0.8 ± 0.7 at the final follow‐up (P < 0.01). The mean JOA improved from preoperative 18.5 ± 2.9 to 26.9 ± 1.1 at the last visit (P < 0.01). The mean ODI was 44.3 ± 6.7 and significantly decreased to 9.3 ± 1.9 at the final observation (P < 0.01). Patient‐reported outcomes as measured by Kirkaldy‐Willis criteria were excellent in 21 cases, good in 16 cases, and fair in one case; there were no poor outcomes. Lumbosacral angle increased from the preoperative values of 21.7° ± 1.8° to the postoperative values of 26.4° ± 1.4° (P < 0.01), with an angle loss of 1.2° ± 0.7° at the last follow‐up. Bone fusion occurred on average 12.8 ± 1.9 months (range, 9–15 months) after surgery. No nonunion, pseudarthrosis, loosening or fracture of instruments occurred at the last follow‐up.
Conclusion
One‐stage posterior debridement, interbody fusion, lumbosacral or lumbopelvic fixation, and postural drainage according to the severity of sacral destruction is an effective and highly safe procedure to treat lumbosacral junction tuberculosis in adults.
... The combination of anterior and posterior approaches could result in the debridement of tuberculosis lesions directly and simultaneously solve the problem of loss of correction. Along with the convenience, there is increased intraoperative risk, with a longer operation time, substantial intraoperative trauma, and concomitant longer hospital stay 10 . The posterior approach to address lumbosacral tuberculosis has been reported by a number of studies since the application of posterior instrumentation 8, 11-13 . ...
... Spinal tuberculosis is more common in the thoracic and lumbar segments of the spine than the lumbosacral region (where it only accounts for 2%-3% of cases) 17 . Many studies have formed a consensus that anterior approaches are accompanied by higher vascular-related complications and loss of corrected lumbosacral kyphosis 8 , and the combination of anterior and posterior approaches had a longer operation time and hospital stay 10 . In recent years, posterior approaches have been paid increasing amounts of attention in the surgical treatment of spinal tuberculosis, and spinal fixation is regarded as a high-efficiency, safe, and reliable method 12,13,18 . ...
Objective:
This study aimed to investigate the clinical effects of surgically treating lumbosacral tuberculosis with a modified posterior unilateral limited laminectomy method for debridement.
Methods:
This retrospective study enrolled a total of 26 patients who were administered in our institution from January 2010 to December 2016, diagnosed with lumbosacral tuberculosis at the L5/S1 level, and underwent one-stage posterior unilateral limited laminectomy as surgical treatment for debridement, allograft of cortical bone grafting, and fixation. The erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) level, visual analog scale (VAS) score, Oswestry Disability Index (ODI), and lumbosacral angle (LA, Cobb's method) were statistically compared, and the American Spinal Injury Association Impairment (ASIA) Scale was compared between the preoperative and postoperative time points to evaluate the clinical outcomes.
Results:
All 26 patients were observed during the follow-up period, and the mean follow-up time was 1.3 ± 0.42 years. The mean age was 56 ± 7.4 years old. The average operation time was 118.1 ± 17.5 min, and the mean bleeding volume was 513.0 ± 79.6 mL. There were no intraoperative complications or tuberculous sinus, and two cases experienced hypostatic pneumonia during hospitalization, which resolved with responsive antibiotics and symptomatic supportive treatment. At the final follow-up, there was no recurrence of tuberculosis, and the ESR (11.8 ± 1.8 mm/h) and CRP (3.0 ± 1.0 mg/L) levels in all patients had returned to normal. The patients with neurologic deficits had improved, and the mean ODI was 79.9 ± 10.6 (87-62) preoperatively and significantly decreased to 20.5 ± 5.7 (11-29) at the final follow-up (P < 0.01). ASIA scale scores were improved by 1~2 grades at the last follow-up. The patients' pain levels were significantly alleviated; the mean VAS score declined to 1.2 ± 0.4 (0-2.5) at the final follow-up compared to 7.5 ± 1.6 (6.5-8.5) preoperatively (P < 0.01). All patients achieved bony graft fusion at an average time of 6.8 ± 1.2 months. Physiological lumbar lordosis was significantly improved, and the mean LA before operation was 17.6° ± 2.1°, which was significantly different from the postoperative LA (29.3° ± 7.4°, P < 0.01) at the final follow up. The LA (27.1° ± 5.5°, P = 0.15) slightly rebounded but without significance compared to the postoperative level.
Conclusion:
Only posterior approach by unilateral limited laminectomy for debridement could be served as an effective and safe method to treat short-segment lumbosacral tuberculosis without extensive anterior sacral and gravitation abscesses.
... However, problems such as subsidence, stress occlusion, and radiation opacity can affect surgical planning [14][15][16][17][18][19][20] . Although the transverse process had advantages of reducing trauma, shortening hospital stay, the bone defects caused by the lumbar spine TB are larger than these in thoracic spine which the transverse processes of lumbar spine have deeper anatomical characteristics limited by difficulty in being exposed and which the mechanical requirements of lumbar spine are higher than thoracic spine [21][22][23][24] . Therefore, this study aimed to find a new method of bone grafting to provide support and promote bone fusion to reduce the incidence of complications. ...
... yuan, and 340.00 ± 167.20 mL, respectively. Compared with the iliac crest or fibula graft used in previous studies [17][18][19][20][21][22][23][24] , the use of the LSP could reduce trauma and bleeding, shorten surgical and hospitalization times, decrease postoperative drainage volumes, and reduce postoperative complication rates. The LSP are present in the surgical exposure area during the posterior approach, which can reduce bleeding and trauma. ...
A retrospective study investigated the results of the lamina with spinous process (LSP) as a bone graft in one-level thoracic or lumbar spinal tuberculosis with the one-stage posterior approach of debridement, fusion and internal instrumentation. Data from 35 patients from January 2013 to December 2015 were analysed. Surgery time, blood loss, hospitalization time, drainage volume, and follow-up (FU) duration were recorded. The visual analogue scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), American Spinal Injury Association (ASIA) grade, segmental angle, and bone fusion were compared between preoperative and final FU. All of the patients were followed up for a mean 43.90 ± 10.39 months. The mean age, surgery time, blood loss, hospitalization time, hospital cost and drainage volume were 33.65 ± 11.06 years, 182.40 ± 23.82 min, 280.80 ± 76.82 mL, 14.05 ± 3.58 days, 74,382.00 ± 11,938.00 yuan, and 340.00 ± 167.20 mL, respectively. VAS and ODI were significantly improved at the final FU. The ESR and CRP recovered to normal. The mean angle of 24.35 ± 5.74°preoperatively showed a significant difference between 1 week, postoperatively and final FU. Although there were the loss of angle at final FU comparing with the 1 week postoperatively, it still maintain the good alignment and the segmental stability. All patients achieved bony fusion with a mean time of 12.90 ± 3.91 months. In conclusion, the LSP as a structural bone graft is reliable, safe and effective for segmental stability reconstruction, which could be one choice for surgical management of thoracic or lumbar spinal TB.
