A posterior versus anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis

Abstract

The purpose of this study was to compare posterior and anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis. These approaches were compared in terms of the operation duration, intraoperative blood loss, bony fusion, intraoperative and postoperative complications, neurological status and the angle of kyphosis. Forty-seven patients with thoracic and lumbar tuberculosis who underwent either the posterior or the anterior approach in combination with debridement, interbody autografting and instrumentation from January 2004 to March 2010 were reviewed retrospectively. In group A (n = 25), the posterior approach was combined with debridement, interbody autografting and instrumentation. In group B (n = 22), the anterior approach was performed in addition to debridement, interbody autografting and instrumentation. All cases were followed up for 12-62 months. There was no statistically significant difference between groups in terms of the operation duration, intraoperative blood loss, bony fusion, intraoperative and postoperative complications, neurological status and the angle of kyphosis (p > 0.05). Good clinical outcomes were achieved in both groups. The posterior approach combined with debridement, interbody autografting and instrumentation is an alternative procedure to treat thoracic and lumbar tuberculosis. The posterior approach is sufficient for lesion debridement. In addition, the posterior approach can maintain spinal stabilisation and prevent loss of corrected vertebral alignment as effectively as the anterior approach.