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

Abstract

Abstract 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), 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). 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.

Keywords

• Spinal tuberculosis
• Consecutive multisegment
• Kyphosis
• Posterior-only approach
• Anterior-only approach
• Deformity correction