One-stage combined anterior-posterior surgery for thoracic and lumbar spinal tuberculosis

Abstract

Context: Surgical intervention is imperative when spinal tuberculosis (TB) is accompanied by severe spinal damage or kyphotic deformity. As one-stage anterior-only or posterior-only surgery for thoracic and lumbar spinal TB has many disadvantages, combined anterior-posterior surgery was proposed to be a more effective strategy. Objective: To examine the clinical outcomes of one-stage combined anterior-posterior surgery for patients with spinal TB. Design: Retrospective investigation design. Setting: All patients were enrolled at the Hangzhou Red Cross Hospital between August 2002 and October 2014. Participants: Sixty-seven patients with thoracic and lumbar spinal TB were studied. Interventions: All patients were treated with one-stage surgery using a combined anterior-posterior approach. Outcome measures: The patients were evaluated preoperatively and postoperatively by measuring their neurological function using the visual analogue scale (VAS) and the Frankel grades, and spinal deformity using the Cobb angle and radiological examinations. All patients were followed up for at least 11 months and up to 96 months. Results: There was a significant postoperative improvement in neurological outcomes, according to VAS scores and Frankel grades. Kyphotic angles were corrected significantly and were maintained during the final follow-up. Bone fusion was achieved within 4–7 months. Conclusion: One-stage surgical treatment via a combined anterior-posterior approach is an effective and feasible method for treating spinal TB.