Comparison of Three Surgical Approaches for Thoracic Spinal Tuberculosis in Adult

Wang, Long-jie; Zhang, Hongqi; Tang, Mingxing; Gao, Qile; Zhou, Zhenhai; Yin, Xingtian

doi:10.1097/brs.0000000000001955

Cited by 84 publications

(91 citation statements)

References 31 publications

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“…Zhang et al [19] reported favorable clinical outcomes of TSTB treatment using the single posterior approach. Liu et al [20] performed posterior debridement, bone grafting, and instrumentation on patients with monosegmental TSTB and achieved satisfactory curative effect, with favorable bone graft fusion and significant improvement in the patients' Cobb angles. Hassan et al [21] treated TSTB patients with the anterior and posterior approaches, respectively, and found that the posterior approach outperformed the anterior one in mean operation time, intraoperative blood loss, and blood transfusion; in addition, the single posterior approach produced favorable surgical outcomes by creating a small wound to access the lesion site when treating TSTB.…”

Section: Discussionmentioning

confidence: 99%

Comparison of single posterior debridement, bone grafting, and instrumentation with single anterior debridement, bone grafting, and instrumentation in treatment of thoracic spinal tuberculosis

Zhou¹,

Li²,

Gong³

et al. 2019

Preprint

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Objective To explore the clinical effect of single posterior debridement, bone grafting, and instrumentation and single anterior debridement, bone grafting and instrumentation in the treatment of thoracic spinal tuberculosis of adult patients. Methods: A retrospective analysis was made by involving 38 adult patients with thoracic spinal tuberculosis from between June 2013 and December 2015. Of the 38 patients, 21 patients were categorized in single anterior approach group and underwent single posterior debridement, bone grafting, and instrumentation (Group A). The remaining 17 patients were classified in single posterior approaches group (Group B), which received single posterior debridement, bone grafting and instrumentation. Clinical manifestations, laboratory and imaging results of the two groups were analyzed subsequently. Results: All patients were followed up for 23.9 ± 3.8 m (range, 19–36 m). Bony fusion was achieved in all bone grafts. The operation time and intraoperative blood loss in group B were significantly less than those in group A (P<0.05). The VAS scores, ESR, and CRP levels 6 weeks after operation and at the final follow-up were significantly lower than the preoperative levels (P<0.05). At the last follow-up, ASIA improvement no significant difference between groups (P>0.05). Furthermore, the postoperative and final-follow-up kyphosis angles in group B were both significantly smaller than those in group A (P<0.05). Group A had a postoperative angle correction rate smaller than group B, and its postoperative angle loss was greater than group B’s (P<0.05). Conclusion: Single posterior debridement, bone grafting, and instrumentation can achieve similar curative effect as single anterior debridement, bone grafting and instrumentation in the treatment of thoracic spinal tuberculosis, but also accompanied by additional advantages of shorter operation time and less bleeding .

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Section: Discussionmentioning

confidence: 99%

Comparison of single posterior debridement, bone grafting, and instrumentation with single anterior debridement, bone grafting, and instrumentation in treatment of thoracic spinal tuberculosis

Zhou¹,

Li²,

Gong³

et al. 2019

Preprint

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“…7 The main goals of surgical treatment involve removal of the focus, complete decompression of nerves, correction of the spinal deformity, and reconstruction of spinal stability. 8 …”

Section: Discussionmentioning

confidence: 99%

Anterior versus posterior surgical approach for lumbosacral tuberculosis

et al. 2018

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ObjectiveTo compare two different approaches for the treatment of lumbosacral tuberculosis.Patients and MethodsIn total, 115 patients who were surgically treated in our department from July 2010 to July 2014 were included in this retrospective study. They were divided into the anterior and posterior approach groups. Intraoperative hemorrhage; the surgery time; the Cobb angle preoperatively, postoperatively, and at the follow-up visit (2 years postoperatively); visual analog scale (VAS) pain scores before and after surgery; and Oswestry Disability Index (ODI) scores before and after surgery were compared between the two groups.ResultsThe Cobb angle and VAS and ODI scores were significantly improved in both groups after surgery. Significant differences were found in the operation time, intraoperative hemorrhage, Cobb angle correction, and loss of correction at the last follow-up. No significant differences were found in the VAS and ODI scores between the groups.ConclusionsThe posterior approach is superior to the anterior approach with respect to the surgery time, intraoperative hemorrhage, and Cobb angle postoperatively and at the last follow-up. When both approaches can be carried out for a patient with lumbosacral tuberculosis, the posterior approach should be favored over the anterior approach.

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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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Comparison of Three Surgical Approaches for Thoracic Spinal Tuberculosis in Adult

Abstract: 3.

Cited by 84 publications

References 31 publications

Comparison of single posterior debridement, bone grafting, and instrumentation with single anterior debridement, bone grafting, and instrumentation in treatment of thoracic spinal tuberculosis

Comparison of single posterior debridement, bone grafting, and instrumentation with single anterior debridement, bone grafting, and instrumentation in treatment of thoracic spinal tuberculosis

Anterior versus posterior surgical approach for lumbosacral 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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