title: A posterior versus anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis.
abstract: OBJECTIVE
  The purpose of this study was to compare posterior and anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis. These approaches were compared in terms of the operation duration, intraoperative blood loss, bony fusion, intraoperative and postoperative complications, neurological status and the angle of kyphosis.
  
  
  METHODS
  Forty-seven patients with thoracic and lumbar tuberculosis who underwent either the posterior or the anterior approach in combination with debridement, interbody autografting and instrumentation from January 2004 to March 2010 were reviewed retrospectively. In group A (n = 25), the posterior approach was combined with debridement, interbody autografting and instrumentation. In group B (n = 22), the anterior approach was performed in addition to debridement, interbody autografting and instrumentation.
  
  
  RESULTS
  All cases were followed up for 12-62 months. There was no statistically significant difference between groups in terms of the operation duration, intraoperative blood loss, bony fusion, intraoperative and postoperative complications, neurological status and the angle of kyphosis (p > 0.05). Good clinical outcomes were achieved in both groups.
  
  
  CONCLUSIONS
  The posterior approach combined with debridement, interbody autografting and instrumentation is an alternative procedure to treat thoracic and lumbar tuberculosis. The posterior approach is sufficient for lesion debridement. In addition, the posterior approach can maintain spinal stabilisation and prevent loss of corrected vertebral alignment as effectively as the anterior approach.
authors: Orthopaedics Department, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors: Xiaobing
authors: X
authors: Pu
authors: Qiang
authors: Q
authors: Zhou
authors: Qinyi
authors: Q
authors: He
authors: Fei
authors: F
authors: Dai
authors: Jianzhong
authors: J
authors: Xu
authors: Zehua
authors: Z
authors: Zhang
authors: Kopjar
authors: K
authors: Branko
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001863:Bone Screws; D016025:Bone Transplantation; D003646:Debridement; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D011182:Postoperative Care; D011859:Radiography; D012189:Retrospective Studies; D013904:Thoracic Vertebrae / Q000382:microbiology; D014399:Tuberculosis, Spinal / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult