One-Stage Debridement Of Lumbosacral Junction Tuberculosis Through Unilateral Musculussacrospinalis Iliac Bone Flap Reserving Posterior Ligamentous Complex

This study intends to investigate the curative effect and safety of one-stage debridement of lumbosacral vertebral tuberculosis through unilateral musculussacrospinalis iliac bone flap approach reserving posterior ligamentous complex (PLC). A total of 385 lumbosacral vertebral tuberculosis patients received surgery in Guizhou People's Hospital were enrolled. The patients were divided into four groups, including unilateral musculussacrospinalis iliac bone flap approach group, anterolateral approach group, posterior lesions debridement + bone graft fusion + internal fixation group, and posterior combined anterolateral approach internal fixation group. The intraoperative blood loss, operation time, postoperative drainage time, hospital stays, ESR, Cobb angle, bone graft fusion time, VAS pain score, Frankel classification, and complications were observed and compared. The intraoperative blood loss, duration of postoperative drainage, hospital stay and bone graft fusion time in unilateral musculussacrospinalis iliac bone flap approach group were significantly shorter than those in other groups (P< 0.05). ESR, Cobb angle, and VAS score decreased at 3 months after operation in all groups. The Cobb angle and VAS score obviously declined in test group compared with other groups (P< 0.05). The proportion of neurological function improvement in test group was better than the other groups. The curative efficacy achieved 93.65%, while no recurrence occurred in test group at 12 months after operation. Unilateral musculussacrospinalis iliac bone flap approach can effectively present the lesion area, which is suitable to completely clear the lesions and easy for intervertebral bone graft to promote bone graft fusion and prevent protrusion deformity.