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- Title
Surgical treatment of thoracolumbar spinal tuberculosis—a multicentre, retrospective, case-control study.
- Authors
Tang, Yong; Wu, Wen-jie; Yang, Sen; Wang, Dong-Gui; Zhang, Qiang; Liu, Xun; Hou, Tian-Yong; Luo, Fei; Zhang, Ze-hua; Xu, Jian-zhong
- Abstract
Background: The purpose of this multicentre, retrospective study was to evaluate the safety and efficacy of different surgical approaches for treating thoracolumbar tuberculosis. Methods: This study reviewed 132 patients with thoracolumbar tuberculosis in six institutions between January 1999 and January 2015 surgically treated by an anterior-only approach (n = 22, group A), an anterior combined with posterior approach (n = 79, group B), and a posterior-only approach (n = 31, group C). All patients were treated with standard antituberculosis drugs pre- and postoperatively and were followed regularly after surgery. Clinical symptoms, nerve function, and the erythrocyte sedimentation rate were observed, and kyphosis correction and bone fusion were evaluated by X-ray or computed tomography. Results: At the last follow-up, all patients had achieved bone fusion, relief from pain, and neurological recovery. The Cobb angle was improved; however, the Cobb angle showed a degree of loss at the final follow-up after all three surgical approaches. Further comparisons revealed a difference in angle loss at the final follow-up among the three groups; groups B and C were superior to group A in maintenance of the correction. The posterior-only approach was characterized by a shorter operative time and reduced blood loss. Conclusions: Surgery by a posterior-only approach is superior to that by an anterior-only approach and anterior combined with posterior approach in terms of permanent kyphosis correction and spinal stability maintenance. Therefore, we recommend surgery by a posterior-only approach as the optimized treatment for thoracolumbar tuberculosis if the indications for this treatment are met.
- Subjects
ANTITUBERCULAR agents; PREOPERATIVE risk factors; SURGICAL blood loss; BLOOD sedimentation; COMPUTED tomography; CONVALESCENCE; PATIENT aftercare; KYPHOSIS; LUMBAR vertebrae; MEDICAL cooperation; ORTHOPEDIC surgery; POSTOPERATIVE period; RESEARCH; SPINAL fusion; SPINAL tuberculosis; THORACIC vertebrae; X-rays; PAIN management; DECISION making in clinical medicine; TREATMENT effectiveness; RETROSPECTIVE studies; CASE-control method; PREOPERATIVE period; TREATMENT duration; SURGERY
- Publication
Journal of Orthopaedic Surgery & Research, 2019, Vol 14, Issue 1, pN.PAG
- ISSN
1749-799X
- Publication type
Article
- DOI
10.1186/s13018-019-1252-4