Anterior versus posterior surgical approach for lumbosacral tuberculosis

Zheng, Bin; Hao, Dingjun; Guo, Hua; He, Baorong

doi:10.1177/0300060518764933

Cited by 19 publications

(19 citation statements)

References 16 publications

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“…16 On the contrary, many authors have reported that posterior approaches may be better at some of the above parameters than anterior or even combined approac hes. 13,30,31 One of these had disproportionately more thoracic spinal TB cases in anterior group than the posterior group, which may have influenced the aforementioned outcome. 32,33 Theoretically, either of them have their own advantages, with anterior providing better debridement, while posterior giving more stability and less loss of correction of deformity; hence, the rationale of combining them for select cases.…”

Section: Posterior Approachmentioning

confidence: 98%

Surgical Approaches in Management of Spinal Tuberculosis

Kumar

Salaria

Aggarwal

et al. 2021

Ann Natl Acad Med Sci

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Although the management of spinal tuberculosis (TB) is mainly medical, there are select surgical interventions for the same, especially in the event of complications. However, with multiple choices with regard to approaches and surgical techniques, one is often left with too many options. We, therefore, performed a literature review on the subject with respect to the surgical approaches to control spinal TB. Our aim is to enable the reader to understand the rationale behind various surgical approaches and techniques involved in managing spinal TB.

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Section: Posterior Approachmentioning

confidence: 98%

Surgical Approaches in Management of Spinal Tuberculosis

Kumar

Salaria

Aggarwal

et al. 2021

Ann Natl Acad Med Sci

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“…The surgical treatments include anterior surgery, posterior surgery, and combined anteriorposterior surgery [5,6]. However, loss of correction is the major complication of the anterior surgery, due to the quality of the graft and the stability of instrumentation [7][8][9]. Combined anterior-posterior surgery was developed to address the loss of correction complication.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis

Wang

Hua

et al. 2020

BMC Surg

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Background: The bony fusion of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis has not been explained in detail. We aimed to analyze the efficacy of bony fusion of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis. Methods: We treated 32 thoracic or thoracolumbar tuberculosis patients by one-stage posterior debridement, allograft bone graft using titanium mesh, posterior instrumentation, and fusion from May 2011 to September 2015. The American Spinal Injury Association neurological classification, visual analog scale, and Oswestry disability index scores were analyzed preoperatively, postoperatively, and at final follow-up. The Cobb angles were recorded to evaluate the kyphosis correction and the loss of correction. The bony fusion was evaluated by X-ray and computed tomography images, and the bony fusion classifications were recorded. Results: All patients had pain relief. The erythrocyte sedimentation rate, C-response protein, and hepatorenal function were normal at final follow-up. The American Spinal Injury Association neurological classification, visual analog scale, and Oswestry disability index scores were improved in all the patients. All patients achieved bone fusion. Twenty-eight patients achieved complete fusion (Grade I), whereas only four patients achieved partial fusion (Grade II). The preoperative Cobb angle was 33.6 ± 9.3°. The Cobb angle was reduced to 10.6 ± 2.6°postoperatively and was found to be 11.4 ± 3.1°at the final follow-up. The mean angle correction was 23.0 ± 8.9°, and the correction rate was 66.2 ± 12.2%. The mean angle lost was 0.8 ± 0.9°, and the lost rate was 5.8 ± 5.4% at the final follow-up. Conclusions: Allograft bone using titanium mesh in the posterior-only surgical treatment is effective for patients with thoracic and thoracolumbar spinal tuberculosis. It can correct kyphosis, and most patients can achieve complete bony fusion.

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“…[5,6] However, loss of correction is the major complication of the anterior surgery, due to the quality of the graft and the stability of instrumentation. [7][8][9] Combined anterior-posterior surgery was developed to address the loss of correction complication. The combined surgery is indispensable for the wide anterior column defects and severe bone destruction that require long segment bone grafting.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis

Wang

Hua

et al. 2020

Preprint

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Background: The bony fusion of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis has not been explained in detail. We aimed to analyze the efficacy of bony fusion of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis.Methods: We treated 32 thoracic or thoracolumbar tuberculosis patients by one-stage posterior debridement, allograft bone graft using titanium mesh, posterior instrumentation, and fusion from May 2011 to September 2015. The American Spinal Injury Association neurological classification, visual analog scale, and Oswestry disability index scores were analyzed preoperatively, postoperatively, and at final follow-up. The Cobb angles were recorded to evaluate the kyphosis correction and the loss of correction. The bony fusion was evaluated by X-ray and computed tomography images, and the bony fusion classifications were recorded.Results: All patients had pain relief. The erythrocyte sedimentation rate, C-response protein, and hepatorenal function were normal at final follow-up. The American Spinal Injury Association neurological classification, visual analog scale, and Oswestry disability index scores were improved in all the patients. All patients achieved bone fusion. Twenty-eight patients achieved complete fusion (Grade I), whereas only four patients achieved partial fusion (Grade II). The preoperative Cobb angle was 33.6±9.3°. The Cobb angle was reduced to 10.6±2.6° postoperatively and was found to be 11.4±3.1° at the final follow-up. The mean angle correction was 23.0±8.9°, and the correction rate was 66.2±12.2%. The mean angle lost was 0.8±0.9°, and the lost rate was 5.8±5.4% at the final follow-up.Conclusions: Allograft bone using titanium mesh in the posterior-only surgical treatment is effective for patients with thoracic and thoracolumbar spinal tuberculosis. It can correct kyphosis, and most patients can achieve complete bony fusion.

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Anterior versus posterior surgical approach for lumbosacral tuberculosis

Cited by 19 publications

References 16 publications

Surgical Approaches in Management of Spinal Tuberculosis

Surgical Approaches in Management of Spinal Tuberculosis

The efficacy of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis

The efficacy of allograft bone using titanium mesh in the posterior-only surgical treatment of thoracic and thoracolumbar spinal tuberculosis

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