Surgical treatment of thoracic spinal tuberculosis -A Multi-center retrospective study.

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Surgical treatment of thoracic spinal tuberculosis -A Multi-center retrospective study.

World Neurosurg. 2017 Dec 02;:

Authors: Wu W, Lyu J, Liu X, Luo F, Hou T, Zhou Q, Li Z, Chen Y, Li LT, Zheng Y, Wang G, Xu J, Zhang Z

Abstract
OBJECTIVE: The aim present multicenter retrospective study is to assess safety and effectiveness of different surgery strategy in thoracic tuberculosis, and to provide a reference for surgical treatment of thoracic tuberculosis.
MATERIALS AND METHODS: This study reviewed 394 patients with thoracic tuberculosis who were treated in six institution between January 2000 and January 2015. There were 208 males and 186 females with average ages of 34.92±13.14 years (range 5-76 years). 73 patients underwent one-stage anterior surgery (Group A); 84 underwent an anterior combined posterior surgery (Group B); 237 underwent one-stage posterior surgery (Group C). Clinical outcome, laboratory indexes and radiological results were analyzed to observe the advantage of posterior approach surgery.
RESULTS: All cases were followed up for about 26 to 60 months (average of 37 months). At the last follow-up, all patients reached bone fusion, pain relief and neurological recovery. There were significant differences before and after treatment in terms of VAS and ODI (P<0.05). Posterior approach significantly improved kyphosis (P<0.05).
CONCLUSION: Posterior fixation is superior to anterior fixation in the correction of kyphosis and maintenance of spinal stability. One stage posterior surgery can achieve the same efficacy as anterior-only or combined surgery, and less trauma, less blood loss and shorter operative times. However, for wide lesions or paraspinal abscesses, severe bone destruction and anterior and middle column defects which are too large after debridement to require long segment bone grafting, the anterior combined posterior approach is indispensable.
TRIAL REGISTRATION: The study was approved by the Institutional Ethics Review Board, the First Affiliated Hospital of Third Military Medical University, PLA; written informed consent was obtained from all patients or guardians.

PMID: 29208449 [PubMed - as supplied by publisher]

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