Thoracolumbar spinal tuberculosis with psoas abscesses treated by one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural drainage

Pang, Xiaoyang; Shen, Xiongjie; Wu, Ping; Luo, Chenke; Zhang, Xu; Wang, Xiyang

doi:10.1007/s00402-013-1722-9

Cited by 40 publications

(38 citation statements)

References 24 publications

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“…It appears that anterior and posterior instrumentation can achieve similar and good results in correcting the deformity and maintaining that correction, which were in accordance with our results. However, many researchers believe that the anterior approach easily results in nerve and vascular injuries, increasing surgical complications [25,26]. In the current study, we reviewed four reports and concluded that there was no significant difference in the surgery-related complications between posterior instrumentation group and anterior instrumentation group.…”

Section: Discussionmentioning

confidence: 58%

RETRACTED ARTICLE: Clinical efficacy of posterior versus anterior instrumentation for the treatment of spinal tuberculosis in adults: a meta-analysis

Yang

et al. 2014

J Orthop Surg Res

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BackgroundThe aim of our study was to evaluate the clinical efficacy of posterior vs. anterior instrumentation for the treatment of spinal tuberculosis in adults.MethodsThe electronic databases such as PubMed, MEDLINE, Springer, EMBASE, Google scholar, and Cochrane library were searched to select the potentially relevant reports that compared the efficacy of posterior instrumentation group (group A) with anterior instrumentation group (group B) in the treatment of spinal tuberculosis. Outcome assessments were correction of angle, loss of correction, fusion rate of the grafting bone, and complications after surgery.ResultsThis meta-analysis included four trials published between 2006 and 2012, involving 291 adult patients (group A, 154; group B, 137) with spinal tuberculosis. The overall meta-analysis showed that there were no significant differences (P > 0.01) between group A and group B in correction of angle and loss of correction at final follow-up after operation The pooled WMD (weighted mean difference) of group A and group B was 2.85 (95% CI (confidence interval) = -1.25 ~ 6.94) and 1.14 (95% CI = -3.07 ~ 5.34), respectively. Besides, no significant differences (P > 0.01) were observed in fusion rate of the grafting bone and complications after operation between group A and group B, and the pooled ORs (odds ratio) were 0.65 (95% CI = -0.23 ~ 1.85) and (95% CI = -0.19 ~ 1.50), respectively.ConclusionsOur results suggested that the posterior instrumentation appeared to have the same clinical outcome with the anterior instrumentation in the treatment of the adult patients with spinal tuberculosis.

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Section: Discussionmentioning

confidence: 58%

RETRACTED ARTICLE: Clinical efficacy of posterior versus anterior instrumentation for the treatment of spinal tuberculosis in adults: a meta-analysis

Yang

et al. 2014

J Orthop Surg Res

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“…ESR and CRP can’t return to normal within 2–4 weeks after chemotherapy, because of abscesses persisting, but TB toxicity symptoms may be relieved. When ESR decreased below 40–80 mm/h or returned to normal, and CRP was progressively decreased[22, 24, 27, 28], the surgery was recommended. In addition, if the patients encountered neural function aggravation, defecation function disturbance, and paraplegia, the surgical intervention should be perfomed immediately.…”

Section: Discussionmentioning

confidence: 99%

Comparison between titanium mesh and autogenous iliac bone graft to restore vertebral height through posterior approach for the treatment of thoracic and lumbar spinal tuberculosis

Gao

Deng

et al. 2017

PLoS ONE

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ObjectTo compare the clinical efficacy of titanium mesh cages and autogenous iliac bone graft to restore vertebral height through posterior approach in patients with thoracic and lumbar spinal tuberculosis.Method59 patients with spinal tuberculosis underwent interbody fusion and internal fixation through posterior approach in our department from January 2011 to December 2013. In group A, 34 patients obtained titanium mesh for the reconstruction of vertebral height, among them 25 patients (group A1) suffered from single-segment spinal tuberculosis, and 9 patients, (group A2) had multi-segment spinal tuberculosis. In group B, 25 patients got autogenous iliac bone graft to restore vertebral height, including 24 patients with single-segment spinal tuberculosis (group B1), and 1 patient with multi-segment spinal tuberculosis (group B2). The clinical efficacy was evaluated based on average operation time, blood loss, hospital stays, hospitalization expenses, visual analog scale (VAS), Oswestry Disability Index (ODI), erythrocyte sedimentation rate (ESR), C-Reactive protein (CRP), neurological function recovery, bony fusion, intervertebral height, Cobb angle and postoperative complications.ResultsFinal follow-up time was an average of 35.5 months ranging from 15 to 56 months. All patients were completely cured and obtained solid bone fusion. The bony fusion time was 9.4±6.1 months in group A1, 10.2±2.7 months in group A2 and 8.7±3.6 months in group B1. There were no significant difference among three groups (P>0.05). The Cobb correction and restoration of intervertebral height significantly improved compared with those in preoperation, but without significant difference among three groups (P>0.05). The loss of angular correction and intervertebral height in group A1 were found to be less than those in group B1 (P<0.05), but with no significant difference between group A1 and group A2, and between group A2 and group B1 (P>0.05). Patients in group B1 got the most loss of angular correction and intervertebral height. In addition, neurological function was revealed to be significantly improved after surgery. There were significant differences of VAS, ODI, ESR and CRP between preoperation and postoperation at the final follow-up time (P<0.05), with no significant difference among three groups (P>0.05). No statistically significant difference was found when analyzing blood loss, hospital stays, hospitalization expenses, and corrective cost among three groups (P>0.05). Complications included cerebrospinal fluid leakage (2 cases in group A1 and group A2), sinus formation (3 cases in group A1, group A2 and group B1), and intervertebral infection (1 case in group B1), but no implant failure or donor site complications was found in any patient.ConclusionsTitanium mesh cages could obtain good clinical efficacy comparable to autogenous iliac bone graft when treating single-segment spinal tuberculosis, and may be better than autogenous iliac bone graft for treating multi-segment spinal tuberculosis.

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“…Pang et al (14) and and Sahoo et al (19) reported considerable success using one-stage posterior approach in the treatment of spinal TB. Guven et al (2) also reported satisfactory function of stabilization and kyphosis prevention after posterior transpedicular debridement and instrumented fusion without anterior debridement.…”

Section: Discussionmentioning

confidence: 98%

Efficacy and Safety of Posterior Versus Combined Posterior and Anterior Approach for the Treatment of Spinal Tuberculosis: A Meta-Analysis

et al. 2015

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Thoracolumbar spinal tuberculosis with psoas abscesses treated by one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural drainage

Abstract: With standardized anti-TB chemotherapy, thoracolumbar spinal tuberculosis with psoas abscesses could be effectively treated by one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural drainage.

Cited by 40 publications

References 24 publications

RETRACTED ARTICLE: Clinical efficacy of posterior versus anterior instrumentation for the treatment of spinal tuberculosis in adults: a meta-analysis

RETRACTED ARTICLE: Clinical efficacy of posterior versus anterior instrumentation for the treatment of spinal tuberculosis in adults: a meta-analysis

Comparison between titanium mesh and autogenous iliac bone graft to restore vertebral height through posterior approach for the treatment of thoracic and lumbar spinal tuberculosis

Efficacy and Safety of Posterior Versus Combined Posterior and Anterior Approach for the Treatment of Spinal Tuberculosis: A Meta-Analysis

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