PURPOSE: There are few papers in the literature comparing outcomes between antero-posterior and posterior-only approaches for treating thoracolumbar tuberculosis (T10–L2) in children. METHODS: We performed a retrospective review of 47 children who were diagnosed and treated as thoracolumbar tuberculosis (T10–L2) in our department from January 2005 to June 2009. Forty-seven cases of thoracolumbar tuberculosis were treated by two different surgical approaches. All the cases were divided into two groups: 25 cases in group A underwent one-stage posterior debridement, transforaminal fusion, and instrumentation, and 22 cases in group B underwent anterior debridement, bone graft, and posterior instrumentation in a single- or two-stage procedure. Two approaches were compared in terms of average operative time, blood loss, hospitalizations, bony fusion, intraoperative and postoperative complications, the Oswestry disability index score, neurological status, and the angle of kyphosis. RESULTS: All 47 patients (24 M/23F), averaged 9.1 ± 2.6 years old (range 5 to 14 years), who were followed up for mean of 49.3 ± 8.6 months (range 36 to 65 months). Spinal tuberculosis (TB) was completely cured, and the grafted bones were fused in 9 months in all cases. It was obviously that the average operative time, blood loss, hospitalization, and complication rate of group A was less than those of group B. Good clinical outcomes were achieved in both groups. CONCLUSIONS: Both the antero-posterior and posterior approaches can effectively heal T10–L2 vertebral tuberculosis, but the average surgical time, blood loss, complications, and hospital stay following the posterior approach are prominently less than those following the antero-posterior approach. It might be a better surgical treatment for thoracic spinal tuberculosis in children with poor health status, especially for cases in early phase of bone destruction and/or mild and moderate kyphosis.
PURPOSE: There are few papers in the literature comparing outcomes between antero-posterior and posterior-only approaches for treating thoracolumbar tuberculosis (T10–L2) in children. METHODS: We performed a retrospective review of 47 children who were diagnosed and treated as thoracolumbar tuberculosis (T10–L2) in our department from January 2005 to June 2009. Forty-seven cases of thoracolumbar tuberculosis were treated by two different surgical approaches. All the cases were divided into two groups: 25 cases in group A underwent one-stage posterior debridement, transforaminal fusion, and instrumentation, and 22 cases in group B underwent anterior debridement, bone graft, and posterior instrumentation in a single- or two-stage procedure. Two approaches were compared in terms of average operative time, blood loss, hospitalizations, bony fusion, intraoperative and postoperative complications, the Oswestry disability index score, neurological status, and the angle of kyphosis. RESULTS: All 47 patients (24 M/23F), averaged 9.1 ± 2.6 years old (range 5 to 14 years), who were followed up for mean of 49.3 ± 8.6 months (range 36 to 65 months). Spinal tuberculosis (TB) was completely cured, and the grafted bones were fused in 9 months in all cases. It was obviously that the average operative time, blood loss, hospitalization, and complication rate of group A was less than those of group B. Good clinical outcomes were achieved in both groups. CONCLUSIONS: Both the antero-posterior and posterior approaches can effectively heal T10–L2 vertebral tuberculosis, but the average surgical time, blood loss, complications, and hospital stay following the posterior approach are prominently less than those following the antero-posterior approach. It might be a better surgical treatment for thoracic spinal tuberculosis in children with poor health status, especially for cases in early phase of bone destruction and/or mild and moderate kyphosis.
Authors: Steven D Glassman; Keith Bridwell; John R Dimar; William Horton; Sigurd Berven; Frank Schwab Journal: Spine (Phila Pa 1976) Date: 2005-09-15 Impact factor: 3.468
Authors: Feyza Karagöz Güzey; Erhan Emel; N Serdar Bas; Selim Hacisalihoglu; M Hakan Seyithanoglu; Sabri Emin Karacor; Nezih Ozkan; Ibrahim Alatas; Baris Sel Journal: J Neurosurg Spine Date: 2005-12
Authors: Xiaoming Chen; Jingjing Leng; Guoping Liu; Xiaojun Tang; Jie Zhang; Aijun Wang Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi Date: 2021-01-15