Zheng Liu1, Xiyang Wang2, Zhengquan Xu3, Hao Zeng4, Penghui Zhang5, Wei Peng6, Yupeng Zhang7. 1. Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China. Electronic address: liuzheng_0629@sina.com. 2. Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China. Electronic address: 229061878@qq.com. 3. Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China. Electronic address: xzq19xzq88@163.com. 4. Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China. Electronic address: 1985008521@qq.com. 5. Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China. Electronic address: zph12zph13@sina.com. 6. Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China. Electronic address: pengwei12pw13@sina.com. 7. Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China. Electronic address: zyp19zyp89@163.com.
Abstract
OBJECTIVE: The current study compared clinical outcomes of two diverse therapeutic strategies for upper thoracic (T1-4) spinal tuberculosis with neurological deficits in elderly patients. METHODS: A retrospective analysis was performed on 18 cases undergoing single-stage posterior transpedicular decompression, debridement, interbody fusion, and instrumentation (Group A). Sixteen cases underwent single- or two-stage anterior debridement, bone grafting, and posterior instrumentation (Group B). The clinical and radiographic results for these patients were analyzed and compared. RESULTS: Patients were followed up for an average of 40.9 ± 4.0 months (range 36-48 months). Results demonstrated that the average operative duration, blood loss, hospital stays, and operative complication rate were lesser for Group A than for Group B. The average fusion time was 8.1 ± 1.5 months and 7.8 ± 2.9 months in Groups A and B, respectively (p>0.05). Cobb's angles were significantly corrected after surgical management, but loss of correction occurred in both groups. All patients had significant postoperative neurological improvement. CONCLUSIONS: Single-stage posterior transpedicular debridement, decompression, interbody fusion and instrumentation might be a better surgical treatment compared with combined posterior and anterior approaches. Such techniques may result in fewer complications and a better quality of life for elderly patients.
OBJECTIVE: The current study compared clinical outcomes of two diverse therapeutic strategies for upper thoracic (T1-4) spinal tuberculosis with neurological deficits in elderly patients. METHODS: A retrospective analysis was performed on 18 cases undergoing single-stage posterior transpedicular decompression, debridement, interbody fusion, and instrumentation (Group A). Sixteen cases underwent single- or two-stage anterior debridement, bone grafting, and posterior instrumentation (Group B). The clinical and radiographic results for these patients were analyzed and compared. RESULTS:Patients were followed up for an average of 40.9 ± 4.0 months (range 36-48 months). Results demonstrated that the average operative duration, blood loss, hospital stays, and operative complication rate were lesser for Group A than for Group B. The average fusion time was 8.1 ± 1.5 months and 7.8 ± 2.9 months in Groups A and B, respectively (p>0.05). Cobb's angles were significantly corrected after surgical management, but loss of correction occurred in both groups. All patients had significant postoperative neurological improvement. CONCLUSIONS: Single-stage posterior transpedicular debridement, decompression, interbody fusion and instrumentation might be a better surgical treatment compared with combined posterior and anterior approaches. Such techniques may result in fewer complications and a better quality of life for elderly patients.