Treatment of lumbosacral tuberculosis by anterior internal fixation combined with computed tomography angiography

Abstract

Objective: This study aims to examine the iliac vascular space in patients with lumbosacral tuberculosis and to evaluate the feasibility of anterior internal fixation for lumbosacral tuberculosis. Methods: A retrospective analysis was performed in 36 patients with lumbosacral tuberculosis. The preoperative three-dimensional computed tomography angiography images were analyzed for anatomical parameters. Results: There were large variations among the anterior lumbosacral iliac vessels. Predominantly, the left iliac vein and the right iliac artery formed the two borders of the triangular iliac vascular space in the coronal plane. The mean distance between the iliac vessels straddle point and the inferior endplate of L5 was 15.01 ± 15.08 mm. In the sagittal plane, presacral abscess increased the distance between the posterior iliac vessel and the anterior vertebra. The distances on the left and right sides were 9.94 ± 6.03 and 10.15 ± 5.46 mm, respectively, at the inferior endplate of L5 and were 11.90 ± 6.97 and 11.68 ± 5.52 mm, respectively, at the superior endplate of S1. Conclusions: The space on sagittal plane occupied by presacral abscess may push forward the vessels and therefore provide opportunities for anterior internal fixation.