Evaluation of the efficacy of retroperitoneoscopic debridement for lumbar tuberculosis: a retrospective study and preliminary results.

BACKGROUND

Lumbar tuberculosis (LTB) is a significant global health concern, often requiring surgical intervention when medical treatment is insufficient. Retroperitoneoscopic debridement offers a minimally invasive approach to manage LTB, potentially reducing complications and recovery time compared to traditional open surgery. However, its efficacy and safety remain understudied. This retrospective cohort study aims to evaluate the clinical outcomes, complication rates, and long-term effectiveness of retroperitoneoscopic debridement in patients with LTB.

METHODS

This retrospective cohort study analyzed patients with LTB and treated with retroperitoneoscopic debridement at our institution from July 2022 to July 2023. Baseline patient characteristics, operative time, operative blood loss, changes in inflammatory markers (e.g., CRP, ESR), complication rates, the visual analog scale (VAS) scores of the back, Oswestry Disability Index (ODI) scores, kyphotic angle changes in infective level and radiological follow-up outcomes were recorded.

RESULTS

Twenty patients with LTB were finally included. The mean operative time, operative blood loss, and postoperative drainage volume were 88.42 ± 7.07 min, 26.32 ± 10.61 ml, and 58.00 ± 11.31 ml, respectively. The mean follow-up time was 20.21 ± 1.41 months. During the follow-up, both VAS score and ODI score were significantly improved at one month, three months postoperative, and the final follow-up, compared with preoperative (P < 0.001). At the final follow-up, the kyphotic angle in the infective level remained good in all patients and no spinal instability was observed. Bone graft fusion rate at the final follow-up was 100%. Compared with preoperative, ESR and CRP were both showed significant decrease at one and three months postoperative (P < 0.001). One patient was found with postoperative complications, and cured after active treatment.

CONCLUSION

Retroperitoneoscopic debridement appears to be a safe and effective minimally invasive approach for treating LTB. However, long-term efficacy requires further validation through prospective studies with larger sample sizes and extended follow-up periods.