Long-segment versus short-segment fixation through a posterior approach for tuberculous spondylodiscitis of the mid-thoracic spine in adults: a study of mid- to long-term efficacy

Abstract

Background This retrospective study aimed to perform comparatively evaluate the mid- to long-term efficacy of long-segment and short-segment fixations via the posterior approach as treatment for tuberculous spondylodiscitis in the mid-thoracic spine. Methods A total of 95 patients with tuberculous spondylodiscitis in the mid-thoracic spine underwent surgery via the posterior approach including single-stage posterior debridement, interbody fusion, and pedicle screw fixation. Long-segment fixations were performed for 46 patients (group A), while short-segment fixations were performed for the other 49 patients (group B). Clinical and radiological outcomes were assessed during mid- to long-term follow-up. Results The average follow-up periods for groups A and B were 75.5 ± 11.8 and 76.8 ± 11.6 months, respectively. The operative time and intraoperative blood loss were lower in group B than in group A (P < 0.05). Both management approaches significantly corrected the kyphotic deformity detected either in the early postoperative period or at the final visit after long-term follow-up (P > 0.05). Bony fusion was generated after average periods of 10.8 ± 2.1 months and 11.0 ± 2.0 months in groups A and B, respectively. Favorable outcomes were observed on assessment of neurological function and patients’ well-being at the final follow-up. Conclusion No therapeutic differences were observed between long-segment and short-segment fixation as surgical treatment for mid-thoracic Pott’s disease during mid- to long-term follow-up. Kyphotic deformity and neurological impairment were significantly relieved via both posterior fixation approaches, with patients’ well-being reaching a favorable level. Moreover, short-segment fixation led to less blood loss and required a shorter operative time.