Abstract
BackgroundThe purpose of this multicentre, retrospective study was to evaluate the safety and efficacy of different surgical approaches for treating thoracolumbar tuberculosis.MethodsThis study reviewed 132 patients with thoracolumbar tuberculosis in six institutions between January 1999 and January 2015 surgically treated by an anterior-only approach (n = 22, group A), an anterior combined with posterior approach (n = 79, group B), and a posterior-only approach (n = 31, group C). All patients were treated with standard antituberculosis drugs pre- and postoperatively and were followed regularly after surgery. Clinical symptoms, nerve function, and the erythrocyte sedimentation rate were observed, and kyphosis correction and bone fusion were evaluated by X-ray or computed tomography.ResultsAt the last follow-up, all patients had achieved bone fusion, relief from pain, and neurological recovery. The Cobb angle was improved; however, the Cobb angle showed a degree of loss at the final follow-up after all three surgical approaches. Further comparisons revealed a difference in angle loss at the final follow-up among the three groups; groups B and C were superior to group A in maintenance of the correction. The posterior-only approach was characterized by a shorter operative time and reduced blood loss.ConclusionsSurgery by a posterior-only approach is superior to that by an anterior-only approach and anterior combined with posterior approach in terms of permanent kyphosis correction and spinal stability maintenance. Therefore, we recommend surgery by a posterior-only approach as the optimized treatment for thoracolumbar tuberculosis if the indications for this treatment are met.
Highlights
The purpose of this multicentre, retrospective study was to evaluate the safety and efficacy of different surgical approaches for treating thoracolumbar tuberculosis
It has been reported that in cases of progressive single-segment spinal tuberculosis, surgery by a posterior approach can achieve complete debridement, decompression, bone fusion, and internal fixation and can effectively correct spinal kyphosis, which has the advantages of mild trauma, few perioperative complications, low cost, and short recovery time[8, 9]
According to the different surgical approaches, the patients were divided into the following three groups: surgery by an anterior-only approach (n = 22, group A), surgery by an anterior combined with posterior approach (n = 31, group B), and surgery by a posterior-only approach (n = 79, group C) (Table 1)
Summary
The purpose of this multicentre, retrospective study was to evaluate the safety and efficacy of different surgical approaches for treating thoracolumbar tuberculosis. Tang et al Journal of Orthopaedic Surgery and Research (2019) 14:233 approach This treatment strategy can achieve complete debridement, ensure bone graft fusion efficacy, reduce the probability of the infection spreading, correct kyphosis, and prevent the progressive worsening of kyphosis after surgery [1, 3, 4]. This surgical strategy greatly increases the operative time, blood loss volume, surgical trauma, and incidence of perioperative complications [5,6,7]. The purpose of this study was to research the effect of different surgical approaches for curing thoracolumbar tuberculosis and provide guidelines for the selection of appropriate surgical approaches
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
