Objective:

Treatment of lumbosacral tuberculosis is still controversial. Our study was aim to assess the efficacy and feasibility of one-stage posterior debridement, interbody fusion using a structural autograft combined with a titanium mesh cage, and posterior instrumentation for the treatment of lumbosacral tuberculosis with significant vertebral body loss.

Methods:

Between May 2011 and June 2018, 15 patients with lumbosacral tuberculosis with significant vertebral body loss were accepted one-stage posterior debridement, interbody fusion using a structural autograft combined with a titanium mesh cage, and posterior instrumentation. The pre- and postoperative lumbosacral angle, visual analogue scale (VAS), erythrocyte sedimentation rates (ESR), C-reactive protein (CRP) level, and neurological status were assessed.

Results:

Surgery was successful for all patients, and no patients experienced recurrence of the disease during an average 27.3 months (12 to 60) follow-up period. After surgery, the ESR and CRP levels of all patients were returned to normal within 3 months. At the final follow-up, neurological status improved in all patients with neurological deficits preoperatively. The mean preoperative lumbosacral angle was 12.6° (6.7 to 17.9), which increased to 27.7° (24.3 to 34.6) after surgery. The average lumbosacral angle was 26.4° (22.1 to 32.3), with an average loss of 1.4° (0.6 to 2.3) at the final follow-up.

Conclusions:

One-stage posterior debridement, interbody fusion using structural autografts combined with a titanium mesh cage, and posterior instrumentation are effective and safe options in the treatment of lumbosacral tuberculosis with significant vertebral body loss.