Clinical Exploratory Development For Sacroiliac Joint Tuberculosis Treated With Fixed Between Lumbar And Ilium

Objective To evaluate the clinical effect of combined posterior pedicle screw systems fixed between lumbar and ilium, and anterior focus debridement, and bone grafting fusion for treatment of sacroiliac joint tuberculosis, and provide a new choice for the treatment of sacroiliac joint tuberculosis.Methods A retrospective study was performed on 12 cases of sacroiliac joint tuberculosis(12 sides including left side 7 cases and right side 5 cases) who had been treated with posterior pedical screw systems fixed between lumbar and ilium, and combined anterior focus debridement, and bone grafting fusion from march 2008 to october 2013 in our hospital. There were 4 males and 8 females, aging 18?35 years(25.9 years on average). All patients with preoperative accept standard chemotherapy(INH 0.3g+RFP0.45g+EMB0.75g+PZA1.5g,oral,1time/day) anti-tuberculosis treatment for more than 2 weeks, continue to triple anti-tuberculosis treatment one and half year after operation. Majeed SA scoring system was used to evaluate the pelvis function.The preoperative and postoperative Majeed SA scoring system pelvis function assessment by SPSS 19.0 statistical software package for analysis.Results All the cases were followed up for 12?60 months(44.25 months on average). There was no recurrence of the local tuberculosis, and no looseness or breakage of the internal fixation device. All the patients with sacroiliac joint area pain disappeared in 3 months after operation. 7 cases with one side of the lower limb radiation pain have away postoperative 4?6 months. All the patients achieved bony fusion with 4?6 months postoperatively. The preoperative Majeed SA scoring system pelvis function assessment was 52?64 points, an average of 58.41 points. The postoperative Majeed SA scoring system pelvis function assessment at the final follow-up was 67?96 points(average 85.16 points), 9 cases were excellent, 2 cases were good, 1 case was moderate, with an excellent and good outcome rate of 91.66%, there was showing significant difference(P<0.05) when compared with preoperation.Conclusion Combined posterior pedical screw systems fixed between lumbar and ilium, and anterior focus debridement, and bone grafting fusion was one of the effective and feasible, good safe methods treatmenting sacroiliac joint tuberculosis, has the value of clinical application.