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Comparison of single posterior debridement, bone grafting and instrumentation with single-stage anterior debridement, bone grafting and posterior instrumentation in the treatment of thoracic and thoracolumbar spinal tuberculosis.
BMC Surg. 2018 Sep 03; 18(1):71.BS

Abstract

BACKGROUND

To compare the clinical efficacy of single posterior debridement, bone grafting and instrumentation with that of single-stage anterior debridement, bone grafting and posterior instrumentation for treatment of adult patients with thoracic and thoracolumbar spinal tuberculosis (TB).

METHODS

We performed a retrospective analysis of 64 adult patients with thoracic and thoracolumbar spinal TB who underwent surgery between January 2011 and December 2014. Of the 64 patients, 34 patients were treated using a single posterior-only approach (posterior debridement, bone grafting and instrumentation; Group A). Thirty patients were treated with a combined anterior and posterior approach (single-stage anterior debridement, bone grafting and posterior instrumentation; Group B). Clinical manifestations, laboratory and imaging results were subjected to statistical analysis.

RESULTS

The mean (±standard deviation) duration of follow-up was 16.8 ± 1.4 months (range, 10-34). Bony fusion was achieved in all the bone grafts with no loosening or breakage of internal fixation. In both of the groups, the visual analog scale (VAS) pain score, ESR and CRP at 6 weeks after operation and at the most recent follow-up were significantly lower than the preoperative level (p < 0.05). The operation time, intraoperative blood loss and length of hospital stay in group A were significantly less than those in group B (P < 0.05). As of most recent follow-up, no significant between-group difference was observed with respect to the American Spinal Injury Association classification status (p > 0.05). Furthermore, no significant between-group difference was observed with respect to preoperative kyphosis angle, and postoperative angle correction and angle correction rate (P > 0.05). One patient in group A relapsed 20 months after operation, and was successfully treated with debridement using the combined anterior and posterior approach.

CONCLUSION

Single posterior debridement, bone grafting and instrumentation for treatment of thoracic and thoracolumbar spinal TB can achieve similar curative effect as that with single-stage anterior debridement, bone grafting and posterior instrumentation, and is associated with additional advantages of shorter operation time, less bleeding and shorter length of hospital stay.

Authors+Show Affiliations

Department of Orthopedic, Shaanxi Provincial People's Hospital, 256# You-yi West Road, Xi'an, 710068, Shaanxi, People's Republic of China.Department of Orthopedic, Shaanxi Provincial People's Hospital, 256# You-yi West Road, Xi'an, 710068, Shaanxi, People's Republic of China. lww205@sina.com.Department of Orthopedic, Shaanxi Provincial People's Hospital, 256# You-yi West Road, Xi'an, 710068, Shaanxi, People's Republic of China.Department of Orthopedic, Shaanxi Provincial People's Hospital, 256# You-yi West Road, Xi'an, 710068, Shaanxi, People's Republic of China.Department of Nursing administration, Honghui Hospital, Xi'an Jiaotong University College of Medicine, 555# You-yi East Road, Xi'an, 710054, Shaanxi, People's Republic of China. 27426621@qq.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

30176880

Citation

Zhou, Yongchun, et al. "Comparison of Single Posterior Debridement, Bone Grafting and Instrumentation With Single-stage Anterior Debridement, Bone Grafting and Posterior Instrumentation in the Treatment of Thoracic and Thoracolumbar Spinal Tuberculosis." BMC Surgery, vol. 18, no. 1, 2018, p. 71.
Zhou Y, Li W, Liu J, et al. Comparison of single posterior debridement, bone grafting and instrumentation with single-stage anterior debridement, bone grafting and posterior instrumentation in the treatment of thoracic and thoracolumbar spinal tuberculosis. BMC Surg. 2018;18(1):71.
Zhou, Y., Li, W., Liu, J., Gong, L., & Luo, J. (2018). Comparison of single posterior debridement, bone grafting and instrumentation with single-stage anterior debridement, bone grafting and posterior instrumentation in the treatment of thoracic and thoracolumbar spinal tuberculosis. BMC Surgery, 18(1), 71. https://doi.org/10.1186/s12893-018-0405-4
Zhou Y, et al. Comparison of Single Posterior Debridement, Bone Grafting and Instrumentation With Single-stage Anterior Debridement, Bone Grafting and Posterior Instrumentation in the Treatment of Thoracic and Thoracolumbar Spinal Tuberculosis. BMC Surg. 2018 Sep 3;18(1):71. PubMed PMID: 30176880.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of single posterior debridement, bone grafting and instrumentation with single-stage anterior debridement, bone grafting and posterior instrumentation in the treatment of thoracic and thoracolumbar spinal tuberculosis. AU - Zhou,Yongchun, AU - Li,Weiwei, AU - Liu,Jun, AU - Gong,Liqun, AU - Luo,Jing, Y1 - 2018/09/03/ PY - 2018/03/12/received PY - 2018/08/28/accepted PY - 2018/9/5/entrez PY - 2018/9/5/pubmed PY - 2018/11/9/medline KW - Combined anterior and posterior KW - Debridement KW - Single posterior KW - Spinal tuberculosis KW - Thoracic and thoracolumbar SP - 71 EP - 71 JF - BMC surgery JO - BMC Surg VL - 18 IS - 1 N2 - BACKGROUND: To compare the clinical efficacy of single posterior debridement, bone grafting and instrumentation with that of single-stage anterior debridement, bone grafting and posterior instrumentation for treatment of adult patients with thoracic and thoracolumbar spinal tuberculosis (TB). METHODS: We performed a retrospective analysis of 64 adult patients with thoracic and thoracolumbar spinal TB who underwent surgery between January 2011 and December 2014. Of the 64 patients, 34 patients were treated using a single posterior-only approach (posterior debridement, bone grafting and instrumentation; Group A). Thirty patients were treated with a combined anterior and posterior approach (single-stage anterior debridement, bone grafting and posterior instrumentation; Group B). Clinical manifestations, laboratory and imaging results were subjected to statistical analysis. RESULTS: The mean (±standard deviation) duration of follow-up was 16.8 ± 1.4 months (range, 10-34). Bony fusion was achieved in all the bone grafts with no loosening or breakage of internal fixation. In both of the groups, the visual analog scale (VAS) pain score, ESR and CRP at 6 weeks after operation and at the most recent follow-up were significantly lower than the preoperative level (p < 0.05). The operation time, intraoperative blood loss and length of hospital stay in group A were significantly less than those in group B (P < 0.05). As of most recent follow-up, no significant between-group difference was observed with respect to the American Spinal Injury Association classification status (p > 0.05). Furthermore, no significant between-group difference was observed with respect to preoperative kyphosis angle, and postoperative angle correction and angle correction rate (P > 0.05). One patient in group A relapsed 20 months after operation, and was successfully treated with debridement using the combined anterior and posterior approach. CONCLUSION: Single posterior debridement, bone grafting and instrumentation for treatment of thoracic and thoracolumbar spinal TB can achieve similar curative effect as that with single-stage anterior debridement, bone grafting and posterior instrumentation, and is associated with additional advantages of shorter operation time, less bleeding and shorter length of hospital stay. SN - 1471-2482 UR - https://www.unboundmedicine.com/medline/citation/30176880/Comparison_of_single_posterior_debridement_bone_grafting_and_instrumentation_with_single_stage_anterior_debridement_bone_grafting_and_posterior_instrumentation_in_the_treatment_of_thoracic_and_thoracolumbar_spinal_tuberculosis_ L2 - https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-018-0405-4 DB - PRIME DP - Unbound Medicine ER -