Khaled Hassan1, Essam Elmorshidy2. 1. Assiut University Hospital, Assiut, Egypt. 2. Assiut University Hospital, Assiut, Egypt. esmorshidy@hotmail.com.
Abstract
PURPOSE: The aim of this study is to compare the clinical, radiological and functional outcome of anterior versus posterior surgical debridement and fixation in patients with thoracic and lumbar tuberculous spondylodiscitis. PATIENTS AND METHODS: A total number of 42 patients with tuberculous spondylodiscitis of the thoracic and lumbar spine treated surgically were included in this study. Twenty patients (group A) underwent anterior debridement, decompression and instrumentation by anterior approach. Twenty-two patients (group B) were operated by posterolateral (extracavitary) decompression and posterior instrumentation. Operative parameters, clinical, radiographic and functional results for the two groups were analyzed and compared. RESULTS: The average follow-up period was 15 months (range 12-24) in both groups. The average operative time, blood loss and blood transfusion of anterior group were significantly less than the posterior one. There was significant better back pain relief, kyphotic angle correction and less angle loss in the posterior group than anterior. There was no significant difference between the two groups regarding neurological recovery, functional outcome and fusion rate. CONCLUSION: Both anterolateral and posterolateral approaches are sufficient for achieving the goals of surgical treatment of thoracic and lumbar Pott's disease but posterolateral approach allows significant better kyphotic angle correction, less angle loss, better improvement in back pain but unfortunately more operative time and blood loss.
PURPOSE: The aim of this study is to compare the clinical, radiological and functional outcome of anterior versus posterior surgical debridement and fixation in patients with thoracic and lumbar tuberculous spondylodiscitis. PATIENTS AND METHODS: A total number of 42 patients with tuberculous spondylodiscitis of the thoracic and lumbar spine treated surgically were included in this study. Twenty patients (group A) underwent anterior debridement, decompression and instrumentation by anterior approach. Twenty-two patients (group B) were operated by posterolateral (extracavitary) decompression and posterior instrumentation. Operative parameters, clinical, radiographic and functional results for the two groups were analyzed and compared. RESULTS: The average follow-up period was 15 months (range 12-24) in both groups. The average operative time, blood loss and blood transfusion of anterior group were significantly less than the posterior one. There was significant better back pain relief, kyphotic angle correction and less angle loss in the posterior group than anterior. There was no significant difference between the two groups regarding neurological recovery, functional outcome and fusion rate. CONCLUSION: Both anterolateral and posterolateral approaches are sufficient for achieving the goals of surgical treatment of thoracic and lumbar Pott's disease but posterolateral approach allows significant better kyphotic angle correction, less angle loss, better improvement in back pain but unfortunately more operative time and blood loss.
Authors: Andreas F Mavrogenis; Panayiotis D Megaloikonomos; Vasileios G Igoumenou; Georgios N Panagopoulos; Efthymia Giannitsioti; Antonios Papadopoulos; Panayiotis J Papagelopoulos Journal: EFORT Open Rev Date: 2017-11-15