A long-term follow-up study of anterior tibial allografting and instrumentation in the management of thoracolumbar tuberculous spondylitis

Çavuşoğlu, Halit; Kaya, Ramazan; Türkmenoğlu, Osman; Tuncer, Cengiz; Çolak, İbrahim; Aydın, Yunus

doi:10.3171/spi-08/01/030

Cited by 38 publications

(15 citation statements)

References 38 publications

(40 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Cavuşoğlu et al [112] reported long-term results on anterior radical debridement, decompression, and fusion using anterior spinal instrumentation and tibial allograft replacement for management of multilevel spinal TB in 22 patients. Their findings revealed that this technique provides correction of the curvature, prevents further deformation, improves sagittal and coronal balance, and restores neurological function.…”

Section: Multiple Vertebral Diseasementioning

confidence: 99%

Spinal Tuberculosis: Diagnosis and Management

et al. 2012

View full text Add to dashboard Cite

The spinal column is involved in less than 1% of all cases of tuberculosis (TB). Spinal TB is a very dangerous type of skeletal TB as it can be associated with neurologic deficit due to compression of adjacent neural structures and significant spinal deformity. Therefore, early diagnosis and management of spinal TB has special importance in preventing these serious complications. In order to extract current trends in diagnosis and medical or surgical treatment of spinal TB we performed a narrative review with analysis of all the articles available for us which were published between 1990 and 2011. Althoug h the development of more accurate imaging modalities such as magnetic resonance imaging and advanced surgical techniques have made the early diagnosis and management of spinal TB much easier, these are still very challenging topics. In this review we aim to discuss the diagnosis and management of spinal TB based on studies with acceptable design, clearly explained results and justifiable conclusions.

show abstract

Section: Multiple Vertebral Diseasementioning

confidence: 99%

Spinal Tuberculosis: Diagnosis and Management

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Additionally, it can be the most dangerous form of skeletal TB due to its capacity for causing bone destruction, deformity and paraplegia (5). Anti-tuberculous chemotherapy has proven effective in the majority of cases and has become the mainstay of treatment (6), yet it cannot prevent kyphotic degeneration (7,8).…”

Section: Introductionmentioning

confidence: 99%

Two one-stage posterior approaches for treating thoracic and lumbar spinal tuberculosis: A retrospective case-control study

Zhang¹,

Wang²,

Shen³

et al. 2015

Experimental and Therapeutic Medicine

View full text Add to dashboard Cite

Abstract. The aim of this retrospective study was to analyze the results of two surgical treatments for thoracic and lumbar spinal tuberculosis. A total of 73 patients with monosegmental thoracic or lumbar spinal tuberculosis were enrolled from January 2006 to April 2011. The patients were divided into two groups. Patients in group A (n=34) underwent one-stage posterior debridement, limited decompression, bone grafting and internal fixation combined with lamina reconstruction, while those in group B (n=39) underwent one-stage posterior debridement, decompression, bone grafting and posterior instrumentation. Clinical and radiographic results were analyzed and compared between the groups. Patients were followed for a mean 31.3 months (range, 21-42 months). Fusion occurred at 4-12 months (mean, 7.7 months). Surgical complications affected one and five patients in groups A and B, respectively. There was extraction of internal fixation in two group B patients. Postoperatively, there was significant Cobb angle correction in the two groups. By the last follow-up, the Cobb angle and correction loss in group A were significantly better than that in group B; the group A Oswestry Disability Index and Frankel grade were better than that in group B.In conclusion, one-stage posterior limited decompression, bone grafting and internal fixation combined with lamina reconstruction enables rapid management of monosegmental thoracic and lumbar spinal tuberculosis with fewer complications and minimal invasion. IntroductionAs the most common form of extrapulmonary tuberculosis (TB), spinal TB has remained prevalent worldwide, particularly in the less developed and developing countries (1,2), occurring in 1.7% of the world population (3) and accounting for almost 50% of cases of skeletal TB (4). Additionally, it can be the most dangerous form of skeletal TB due to its capacity for causing bone destruction, deformity and paraplegia (5). Anti-tuberculous chemotherapy has proven effective in the majority of cases and has become the mainstay of treatment (6), yet it cannot prevent kyphotic degeneration (7,8). Surgery is therefore frequently imperative for spinal decompression (9).Various surgical methods have been described for treating spinal TB. While there are advantages to exposing the pathological site directly and resecting damaged vertebrae, sequestra of disc and bone, and tuberculous granuloma, which cause predominantly anterior compression of the spinal cord, have led certain authors (10,11) to consider the anterior approach too invasive and often unnecessary in the context of spinal TB. The anterior approach may also involve division of the diaphragm and segmental spinal vessels. An increasing number of surgeons have adopted the method of posterior debridement, bone fusion and posterior fixation to treat monosegmental spinal TB. However, complications resulting from damage to the posterior spinal column due to the posterior approach reduce the surgical effect and affect the patient's quality of life (12). A procedure that caused...

show abstract

“…88 percent of patients achieved solid bony fusion on average 6.3 months postoperatively. Most series report solid bony fusion to occur in over 90 percent of cases [11,13,30,38] and time to fusion from 7.5 to 8.6 months [30,38,39]. Kyphosis correction averaged 8 degrees in present series as compared to 12.5 degrees in other series [21].…”

Section: Discussionmentioning

confidence: 64%

Posterior instrumentation, anterior column reconstruction with single posterior approach for treatment of pyogenic osteomyelitis of thoracic and lumbar spine

et al. 2012

View full text Add to dashboard Cite

Purpose Surgical treatment of thoracolumbar osteomyelitis consists of radical debridement, reconstruction of anterior column either with or without posterior stabilization. The objective of present study is to evaluate a case series of patients with osteomyelitis of thoracic and lumbar spine treated by single, posterior approach with posterior instrumentation and anterior column reconstruction. Methods Seventeen patients underwent clinical and radiological evaluation pre and postoperatively with latest follow-up at 19 months (8-56 months) after surgery. Parameters assessed were site of infection, causative organism, angle of deformity, blood loss, duration of surgery, ICU stay, deformity correction, time to solid bony fusion, ambulatory status, neurologic status (ASIA impairment scale), and functional outcome (KirkaldyWillis criteria). Results Mean operating time was 207 min and average blood loss 1,150 ml. Patients spent 2 (1-4) days in ICU and were able to walk unaided 1.6 (1-2) days after surgery. Infection receded in all 17 patients postoperatively. Solid bony fusion occurred in 15 out of 17 patients (88 %) on average 6.3 months after surgery. Functional outcome was assessed as excellent or good in 82 % of cases. Average deformity correction was 8 (1-18) degrees, with loss of correction of 4 (0-19) degrees at final follow-up. Conclusions Single, posterior approach addressing both columns poses safe alternative in treatment of pyogenic vertebral osteomyelitis of thoracic and lumbar spine.It proved to be less invasive resulting in faster postoperative recovery.

show abstract

A long-term follow-up study of anterior tibial allografting and instrumentation in the management of thoracolumbar tuberculous spondylitis

Cited by 38 publications

References 38 publications

Spinal Tuberculosis: Diagnosis and Management

Spinal Tuberculosis: Diagnosis and Management

Two one-stage posterior approaches for treating thoracic and lumbar spinal tuberculosis: A retrospective case-control study

Posterior instrumentation, anterior column reconstruction with single posterior approach for treatment of pyogenic osteomyelitis of thoracic and lumbar spine

Contact Info

Product

Resources

About