Transverse process strut and titanium mesh cages in the stability reconstruction of thoracic single segment tuberculosis: a retrospective single-center cohort study

Abstract

Background A retrospective and comparative study of transverse process strut (TPS, Group A) compared with titanium mesh cages (TMCs, Group B) in the reconstruction of thoracic stability through the one-stage posterior approach to treat single-segment tuberculosis. Methods Sixty patients from January 2013 to December 2016 were analyzed and divided into two groups. The following data of clinical and radiographical assessments were observed preoperatively, postoperatively and during follow-up (FU). Results The patients were followed up for an average of 50.20 ± 25.10 months (Group A) and 48.70 ± 27.30 months(Group B) without significant difference. No significant differences were found in the mean of operation time in minutes, blood loss, hospitalization time, drainage and follow-up duration between the groups. The VAS, ODI, ESR and CRP were reduced significantly at the final FU compared with the preoperation values and there was no significance between the groups. Neurological deficits were improved in all patients at the final FU without significant difference between the groups(P > 0.05). The bony fusion times were 5.85 ± 1.82 months and 8.4 ± 5.1 months with significant difference(P < 0.05). Comparing with the preoperative values, the kyphosis angle significantly improved, but at the final FU the significant difference was found between the groups (P < 0.05). The loss of the angular correction and the fused segmental height in group A was lower than that in group B (P < 0.05). Conclusions TPS had a better osseous fusion rate, effective maintenance of fused segment stability which is a good bone graft for surgical management of single-segment thoracic spinal tuberculosis.

Effectiveness and safety analysis of titanium mesh grafting versus bone grafting in the treatment of spinal Tuberculosis: a systematic review and meta-analysis

“…Five articles [ 10 , 24 , 25 , 28 , 29 ] compared the Grade E spinal cord injury assessment. No heterogeneity was found between the results of each study, with P = 0.990 and I 2 = 0%.…”

“…Three articles [ 10 , 24 , 26 ] compared ODI scores. When comparing the lumbar pain scores before surgery and at the last follow-up for spinal tuberculosis treated with titanium mesh grafting, there was heterogeneity among the studies ( I 2 = 94.1%, I 2 = 85.3%).…”

“…Four articles [ 24 – 26 , 29 ] compared the postoperative kyphosis angle. Both titanium mesh grafting and bone grafting were compared before surgery and at the last follow-up.…”

“…A total of 6 articles reported on complications [ 10 , 23 , 24 , 26 – 28 ], encompassing a diverse range of complications such as implant subsidence, cerebrospinal fluid (CSF) leakage, and wound infection. The total sample size was 428 cases, with 215 cases in the titanium mesh grafting group and 213 cases in the bone grafting group.…”

Recent Advances in Nanotechnology-Based Strategies for Bone Tuberculosis Management

“…Surgery aims to remove infected tissue, relieve pain, restore structural stability, and reconstruct bone defects, particularly in cases of significant bone loss or instability [ 53 , 54 , 55 ]. Various materials and methods are employed, including autografts (patient’s own bone), allografts (donor bone), synthetic substitutes such as hydroxyapatite and tricalcium phosphate, vascularized grafts, and custom 3D-printed implants or titanium mesh cages [ 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 ]. Each option offers unique advantages and is chosen based on the defect’s location and extent, the patient’s health, and other individual factors.…”