One-stage anterior debridement, bone grafting and posterior instrumentation vs. single posterior debridement, bone grafting, and instrumentation for the treatment of thoracic and lumbar spinal tuberculosis

Abstract

Anterior debridement and bone grafting with posterior instrumentation may not be the best choice for treating patients with spinal tuberculosis. Single posterior debridement/bone grafting/instrumentation for single-segment of thoracic or lumbar spine tuberculosis produced good clinical results, except in patients who had a psoas abscess.

Outcomes of radical debridement versus no debridement for the treatment of thoracic and lumbar spinal tuberculosis

“…After the technique was introduced, the Hong Kong operation became a popular method to treat spinal tuberculosis [8,15,16]. Taking into account the intense trauma, higher incidence of complications and instability of the spine from the anterior approach [17], more surgical methods paid attention to the treatment of spinal tuberculosis from the posterior approach within the last one to two decades [18][19][20].…”

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

“…The summary of the meta-analysis for correction of angle after surgery is shown in Figure 4. The data of effect on correction of angle were available in all studies (24)(25)(26)(27) (Figure 6). It indicated that the posterior approach group spent less time in the hospital than the combined posterior and anterior approach group.…”

“…All of the studies reported the data on fusion time and fusion rate of the grafting bone after surgery (24)(25)(26)(27). A total of 253 patients (group A, 129; group B, 124) were included to assess the overall effects of fusion time.…”

“…The data on operation time of the surgery was available in 4 studies (24)(25)(26)(27), consisting of 237 patients (group A, 118; group B, 119). The randomeffects model was applied to determine the operation time between the 2 groups due to the evidence of heterogeneity (c 2 ¼ 67.5, I 2 ¼ 96%, P< 0.01).…”

“…Whether the clinical outcomes of the single posterior approach for the treatment of spinal TB are superior to the combined posterior and anterior approach still remains a subject of controversy (20,(24)(25)(26)(27). To achieve an integrative understanding of the clinical response of patients who underwent the posterior approach (group A) or the combined posterior and anterior approach (group B), a systematic review of relevant controlled trials and a meta-analysis was conducted to clarify the differences in these 2 approaches.…”