One-Stage Surgical Treatment for Consecutive Multisegment Thoracic Spinal Tuberculosis with Kyphosis by Posterior-Only Debridement, Interbody Fusion, and Instrumentation

Wu, Wence; Li, Zhechen; Wang, Shenglin; Zhang, Hongjie; Lin, Ruey‐Mo; Lin, Jianhua

doi:10.1016/j.wneu.2019.04.122

Cited by 14 publications

(12 citation statements)

References 25 publications

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“…With advancements in the posterior technique, some surgeons have begun to use posterior-only surgery to treat multisegment thoracic TB. Zhong et al [ 20 ] and Wu et al [ 21 ] treated TB patients with multisegment lesions and kyphosis by posterior-only surgery, and all patients were cured and had no recurrence of TB. For multisegment thoracic and lumbar TB, posterior surgery can be performed with multisegment transforaminal and paravertebral approaches according to the type of lesion; in some indirect operations, the lesion surrounding the spine can be effectively cleared, and the case of TB can be cured [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of consecutive multisegment thoracic and lumbar tuberculosis: anterior-only approach vs. posterior-only approach

et al. 2020

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Purpose: To compare the efficacy, safety, and technical characteristics of anterior-only and posterior-only approach surgeries for the treatment of consecutive multisegment thoracic and lumbar tuberculosis. Methods: Thirty-five patients who developed consecutive multisegment thoracic and lumbar tuberculosis from September 2012 to May 2016 were retrospectively analyzed. Group A was the posterior-only surgery group, and group B was the anterior-only surgery group. The data on the surgery, deformity correction, functional scores, and complications were compared between the two groups. Results: There was no significant difference in the operation time or blood loss between groups A and B (P > 0.05). The preoperative average Cobb angle of kyphosis in groups A and B were 36.2 ± 15.2°and 27.9 ± 7.7°, respectively, which significantly decreased to 4.9 ± 11.8°and 10.4 ± 5.6°after the operation, respectively (P < 0.05). At the final follow-up, the angles were 7.1 ± 10.5°and 14.6 ± 8.0°. The correction angle and correction rate in group A (31.3 ± 16.6°, 88.6 ± 43.6%) were greater than those in group B (17.5 ± 4.4°, 64.9 ± 14.0%) (P < 0.05). There was no significant difference in the loss angle between groups A and B (P > 0.05), but the loss rate in group B (24.0 ± 27.8%) was higher than that in group A (9.6 ± 10.2%) (P < 0.05). There was no significant difference in the incidence of complications between the two groups (P > 0.05). Conclusion: The posterior-only and anterior-only approaches can lead to satisfactory clinical results in the treatment of patients with consecutive multisegment thoracic and lumbar tuberculosis. With posterior-only surgery, kyphosis can be better corrected, and the correction can be better maintained than with anterior-only surgery.

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Section: Discussionmentioning

confidence: 99%

Surgical management of consecutive multisegment thoracic and lumbar tuberculosis: anterior-only approach vs. posterior-only approach

et al. 2020

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“…Furthermore, we also observed that the perioperative complication rate was low (6.0%). Wu et al [24] studied 62 cases of multisegment thoracic spinal TB in patients with kyphosis. Such patients received one-stage posterior surgery of debridement interbody fusion and instrumentation, which prevented TB recurrence during the follow-up duration.…”

Section: Discussionmentioning

confidence: 99%

Single posterior debridement, interbody fusion, and fixation on patients with continuous multivertebral lumbar spine tuberculosis (CMLSTB)

Long

Gong

Cui

et al. 2020

BMC Musculoskelet Disord

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Background Patients with continuous multi-vertebral lumbar spine tuberculosis (CMLSTB) were subjected to single posterior debridement, interbody fusion, and fixation to explore their clinical outcomes. Methods Sixty-seven CMLSTB patients who underwent single posterior debridement interbody fusion and fixation between January 2008 to December 2017 were studied. The operation time, blood loss, perioperative complication rate, cure rate, Visual Analog Scale (VAS), Oswetry disability index (ODI), Japanese Orthopedic Association (JOA), Erythrocyte Sedimentation Rate (ESR), C-reactive protein (CRP), kyphotic Cobb’s angle and time of interbody fusion were analyzed to understand their therapeutic effects on CMLSTB patients. Results The patients were followed up for 20–48 months, with a mean of 24.3 months. The mean operation time was 215.5 min (range, 120–280 min), whereas 818.0 ml of blood was lost (range, 400–1500 ml) with a perioperative complication rate of 6.0% and a cure rate of 95.5%. During the last phase of follow-up, the mean preoperative VAS score (5.7) and ODI (72.0%) decreased significantly to 1.4 (t = 31.4, P<0.01) and 8.4% (t = 48.4, P<0.01), respectively. Alternatively, the mean preoperative ESR and CRP (74.7 mm /h and 69.3 mg/L, respectively) decreased to average values (tESR = 39.7, PESR<0.001; tCRP = 50.2, PCRP<0.001), while the JOA score (13.9) significantly increased to 23.0 (t = − 11.6, P<0.01). The preoperative kyphotic Cobb’s angle (20.5°) decreased to 4.8° after the operation (t = 14.0, P<0.01); however, the kyphotic correction remained intact at the time of follow-up (t = − 0.476, P = 0.635). Furthermore, the mean of interbody fusion time was identified to be 8.8 months (range, 6–16 months). Conclusion Single posterior debridement, interbody fusion, and fixation may be one of the surgical choices for the treatment of CMLSTB patients.

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“…With advancements in the posterior technique, some surgeons have begun to use posterior-only surgery to treat multisegment thoracic TB. Zhong et al [20] and Wu et al [21]treated TB patients with multisegment lesions and kyphosis by posterior-only surgery, and all patients were cured and had no recurrence of TB. For multisegment thoracic and lumbar TB, posterior surgery can be performed with multisegment transforaminal and paravertebral approaches according to the type of lesion; in some indirect operations, the lesion surrounding the spine can be effectively cleared, and the case of TB can be cured [22].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of consecutive multisegment thoracic and lumbar tuberculosis: anterior-only approach vs. posterior-only approach.

Chen¹,

Li²,

Liu³

et al. 2020

Preprint

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Purpose: To compare the efficacy, safety, and technical characteristics of anterior-only and posterior-only approach surgeries for the treatment of consecutive multisegment thoracic and lumbar tuberculosis.Methods: Thirty-five patients who developed consecutive multisegment thoracic and lumbar tuberculosis from September 2012 to May 2016 were retrospectively analyzed. Group A was the posterior-only surgery group, and group B was the anterior-only surgery group. The data on the surgery, deformity correction, functional scores and complications were compared between the two groups.Results: There was no significant difference in the operation time or blood loss between groups A and B (P>0.05). The preoperative average Cobb angle of kyphosis in groups A and B were 36.2±15.2° and 27.9±7.7°, respectively, which significantly decreased to 4.9±11.8° and 10.4±5.6° after the operation, respectively (P<0.05). At the final follow-up, the angles were 7.1±10.5° and 14.6±8.0°, respectively. The correction angle and correction rate in group A (31.3±16.6°, 88.6±43.6%) were greater than those in group B (17.5±4.4°, 64.9±14.0%) (P<0.05). There was no significant difference in the loss angle between groups A and B (P>0.05), but the loss rate in group B (24.0±27.8%) was higher than that in group A (9.6±10.2%) (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: The posterior-only and anterior-only approaches can lead to satisfactory clinical results in the treatment of patients with consecutive multisegment thoracic and lumbar tuberculosis. With posterior-only surgery, kyphosis can be better corrected, and the correction can be better maintained than with anterior-only surgery.

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One-Stage Surgical Treatment for Consecutive Multisegment Thoracic Spinal Tuberculosis with Kyphosis by Posterior-Only Debridement, Interbody Fusion, and Instrumentation

Cited by 14 publications

References 25 publications

Surgical management of consecutive multisegment thoracic and lumbar tuberculosis: anterior-only approach vs. posterior-only approach

Surgical management of consecutive multisegment thoracic and lumbar tuberculosis: anterior-only approach vs. posterior-only approach

Single posterior debridement, interbody fusion, and fixation on patients with continuous multivertebral lumbar spine tuberculosis (CMLSTB)

Surgical management of consecutive multisegment thoracic and lumbar tuberculosis: anterior-only approach vs. posterior-only approach.

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