Thoracic and lumbar tuberculous spondylitis treated by posterior debridement, graft placement, and instrumentation: a retrospective analysis in 19 cases

Güzey, Feyza Karagöz; Emel, Erhan; Baş, Nuri Serdar; S, Hacísalihoğlu; Seyithanoğlu, Mehmet Hakan; Karacor, Sabri Emin; Özkan, Nezi̇h; Alataş, İbrahim; Sel, Barıs

doi:10.3171/spi.2005.3.6.0450

Cited by 74 publications

(49 citation statements)

References 22 publications

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“…One such approach, transpedicular drainage with posterior instrumentation [5,14], may be effective for treating patients who are diagnosed early in the disease process, but not effective for treating patients with major vertebral collapse and/or neurological deficits. Posterior debridement and instrumentation is another approach that has been used in the treatment of spinal tuberculosis [15]; however, posterior instrumentation without anterior support may not provide optimal spinal stability nor prevent the progression of kyphosis [16]. A further approach is anterior radical debridement accompanied by posterior instrumentation [17].…”

Section: Discussionmentioning

confidence: 99%

One-Stage Anterolateral Surgical Treatment for Lumbosacral Segment Tuberculosis

Song

Jing

Chen

et al. 2011

International Orthopaedics (SICOT)

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Section: Discussionmentioning

confidence: 99%

One-Stage Anterolateral Surgical Treatment for Lumbosacral Segment Tuberculosis

Song

Jing

Chen

et al. 2011

International Orthopaedics (SICOT)

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“…These authors have used segmental spinal instrumentation with pedicle screws and rods. In most of these reports, additional procedures such as posterior closing wedge osteotomy, and posterior inter-body fusion using bone grafts with or without cages have been performed [37,[39][40][41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Isolated posterior instrumentation for selected cases of thoraco-lumbar spinal tuberculosis without anterior instrumentation and without anterior or posterior bone grafting

Kumar¹,

Joseph²,

Manur³

2012

Eur Spine J

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Purpose The aim of this prospective study is the analysis of the clinical and radiological outcomes of active thoracolumbar spinal tuberculosis treated with isolated posterior instrumentation without any posterior bone grafting or anterior inter-body bone grafting or anterior instrumentation. Methods The study was a prospective follow-up of 25 patients with active thoraco-lumbar spinal tuberculosis who underwent posterior spinal instrumentation with pedicle screws and rods. These patients had posterior stabilization of the involved segment of the spine without anterior or posterior bone grafting. The mean duration of follow-up was 3.3 years and the minimum duration of follow-up was 2 years. Results The mean kyphotic angle improved from 32.4°p re-operatively to 7.2°in the early follow-up period. Following a minor loss of correction during follow-up, the mean kyphotic angle settled at 11.5°at the time of final follow-up. Inter-body bony fusion was noticed at the final follow-up in all patients despite the absence of anterior bone grafting or cages. Conclusion Posterior instrumented stabilization followed by chemotherapy seems to be adequate for obtaining satisfactory healing of the lesions. Anterior inter-body bony arthrodesis occurs despite the absence of anterior bone grafts or cages. Careful patient selection is critical for successful outcome with this technique.

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“…This surgery was considered too drastic by some authors because it may necessitate division of the diaphragm and segmental vessels [23,24]. Surgeons supporting the posterior approaches report that modern posterior spinal instrumentation can provide rigid fixation and stability [6,7]. Additionally, correcting angular deformity is safer and more effective with posterior instrumentation and fusion, especially with transpedicular instrumentation or anterior decompression plus posterior fixation.…”

Section: Group (N)mentioning

confidence: 99%

“…Additionally, correcting angular deformity is safer and more effective with posterior instrumentation and fusion, especially with transpedicular instrumentation or anterior decompression plus posterior fixation. Guzey et al [6] reported that 19 patients with single segmental tuberculous spondylitis underwent posterior debridement, graft placement and instrumentation: one patient died of a myocardial infarction, and one patient experienced a single broken pedicle screw after three months. The mean angulation in the 13 patients with kyphotic deformities was 18.2°(range 5-42°) preoperatively; this angle was reduced to 17.3°(range 0°-42°) after surgery.…”

Section: Group (N)mentioning

confidence: 99%

“…Posterior instrumentation has become popular as a technique to correct angular deformities and stabilise an unstable spine. Several authors have reported that the use of the posterior approach combined with debridement and instrumentation to treat spinal tuberculosis has led to favourable clinical outcomes [5][6][7]. However, the posterior approach remains controversial because it may affect posterior spinal column stability [8,9].…”

Section: Introductionmentioning

confidence: 99%

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A posterior versus anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis

Zhou

et al. 2011

International Orthopaedics (SICOT)

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Purpose The purpose of this study was to compare posterior and anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis. These approaches were compared in terms of the operation duration, intraoperative blood loss, bony fusion, intraoperative and postoperative complications, neurological status and the angle of kyphosis. Methods Forty-seven patients with thoracic and lumbar tuberculosis who underwent either the posterior or the anterior approach in combination with debridement, interbody autografting and instrumentation from January 2004 to March 2010 were reviewed retrospectively. In group A (n=25), the posterior approach was combined with debridement, interbody autografting and instrumentation. In group B (n=22), the anterior approach was performed in addition to debridement, interbody autografting and instrumentation. Results All cases were followed up for 12-62 months. There was no statistically significant difference between groups in terms of the operation duration, intraoperative blood loss, bony fusion, intraoperative and postoperative complications, neurological status and the angle of kyphosis (p>0.05). Good clinical outcomes were achieved in both groups. ConclusionsThe posterior approach combined with debridement, interbody autografting and instrumentation is an alternative procedure to treat thoracic and lumbar tuberculosis. The posterior approach is sufficient for lesion debridement. In addition, the posterior approach can maintain spinal stabilisation and prevent loss of corrected vertebral alignment as effectively as the anterior approach.

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Thoracic and lumbar tuberculous spondylitis treated by posterior debridement, graft placement, and instrumentation: a retrospective analysis in 19 cases

Cited by 74 publications

References 22 publications

One-Stage Anterolateral Surgical Treatment for Lumbosacral Segment Tuberculosis

One-Stage Anterolateral Surgical Treatment for Lumbosacral Segment Tuberculosis

Isolated posterior instrumentation for selected cases of thoraco-lumbar spinal tuberculosis without anterior instrumentation and without anterior or posterior bone grafting

A posterior versus anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis

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