Surgical Management for Thoracic Spinal Tuberculosis Posterior Only versus Anterior Video-Assisted Thoracoscopic Surgery

Abstract

Study DesignA comparable retrospective study.ObjectTo compare the clinical outcomes of surgical treatment by posterior only and anterior video-assisted thoracoscopic surgery for thoracic spinal tuberculosis (TSTB).Method145 patients with TSTB treated by two different surgical procedures in our institution from June 2001 to June 2014 were studied. All cases were retrospectively analyzed and divided into two groups according to the given treatments: 75 cases (32F/43M) in group A performed single-stage posterior debridement, transforaminal thoracic interbody fusion and instrumentation, and 70 cases (30F/40M) in group B underwent anterior video-assisted thoracoscopic surgery (VATS). Clinical and radiographic results in the two groups were analyzed and compared.ResultsPatients in group A and B were followed up for an average of 4.6±1.8, 4.4±1.2 years, respectively. There was no statistically significant difference between groups in terms of the operation time, blood loss, bony fusion, neurological recovery and the correction angle of kyphotic deformity (P>0.05). Fewer pulmonary complications were observed in group A. Good clinical outcomes were achieved in both groups.ConclusionsBoth the anterior VATS and posterior approaches can effectively treat thoracic tuberculosis. Nevertheless, the posterior approach procedure obtained less morbidity and complications than the other.

One-stage posterior-only approach in surgical treatment of single-segment thoracic spinal tuberculosis with neurological deficits in adults: a retrospective study of 34 cases

“…Paraspinal abscess, if present, would be conquered by appropriate pressure washing and postural drainage. It would certainly be a good choice for some scholars to promote the removal of lesions by a thoracoscope [ 21 ]. In our study, all patients had no recurrence of TB.…”

One-stage posterior approach in the treatment of consecutive multi-segment thoracic tuberculosis with kyphosis

“…Similar results were provided by Zeng et al (17), indicating that the anterior approach should be limitedly applied for severe cervicothoracic tuberculosis. Nevertheless, other authors commented that the posterior approach was associated with more effective deformity correction, and less complications and mortality than the anterior approach (2,5,21). Taken together, anterior and posterior instrumentation have their own surgical indications respectively and thus the selection of the surgical approach should be based on the specific requirements of different kinds of patients.…”

Pulmonary Complications following Thoracic Spinal Surgery: A Systematic Review

“…Among the 14 studies identified, 13 were retrospective studies, 2 3 4 5 6 7 8 9 10 11 12 13 14 and 1 was a prospective study. 15 All but 2 had had a high risk of bias, 4 15 class of evidence IV ( Table 1 ).…”