Clinical Observation Of "Mobile Window" Muscle Space Approach For Treatment Of Multiple Lumbosacral Tuberculosis

Due to the complex anatomy and biomechanics of the affected region, surgical approaches and stabilization methods in patients with lumbosacral tuberculosis remain a clinical challenge. The current study aimed to explore the clinical effects of the "moving window" muscle space approach for debridement and bone grafting, combined with posterior pedicle screw fixation, for treatment of multiple lumbosacral tuberculosis. This study, retrospectively, analyzed a series of 41 patients with multiple lumbosacral tuberculosis, treated by posterior pedicle screw fixation combined with anterior retroperitoneal debridement and bone graft fusion. A total of 25 patients were treated using the anterior "moving window" muscle approach (Modified Group), while 16 patients were treated with the traditional retroperitoneal approach (Traditional Group). All lesions were involved in the L4-S1 segment. There were no significant differences in operation times, bleeding during the operation, hospitalization times, ESR, CRP recovery times, and fusion times between the two groups (P>0.05). The length of abdominal incision in the modified group was 18.08 +/- 2.66 cm, significantly better than that in the traditional group. Visual pain scores in the modified group were lower than those in the traditional group at 24 hours. Moreover, 48 hours after the operation, differences were statistically significant. There were no significant differences in visual pain scores at 72 hours after the operation between the two groups (P>0.05). Treatment of multiple lumbosacral tuberculosis with the "moving window" muscle space approach for debridement and bone grafting, combined with posterior pedicle screw fixation, can significantly reduce surgical trauma, gastrointestinal interference, and complications, without increasing operation times and bleeding. Therefore, this method demonstrates clinical operability and practicability.