title: Outcomes of different surgical procedures in the treatment of spinal tuberculosis in adults.
abstract: OBJECTIVE
  To investigate surgical methods and outcomes in the treatment of spinal tuberculosis (TB) in adults.
  
  
  METHODS
  One hundred and eighty-one patients (average age 39 years) without multiple-level noncontiguous spinal TB were followed up for 22-72 months. The patients were divided into four groups according to surgical procedure on the basis of the position and extension of the foci: group A (74 cases): anterior radical debridement and strut grafting with instrumentation; group B (83 cases): posterior instrumentation and bone grafting with anterior radical debridement and strut grafting in a single- or two-stage procedure; group C (10 cases): extrapleural anterolateral decompression and strut grafting with posterior instrumentation in thoracic or thoracolumbar spine, and group D (27 cases): single-stage transforaminal decompression and posterior instrumentation and fusion.
  
  
  RESULTS
  There was a significant decrease (p < 0.05) in mean preoperative (81%) Oswestry's Disability Index. Except for 24 patients with lumbosacral TB who were only instrumented posteriorly, kyphosis degrees were corrected by a mean of 11.5° in the anterior instrumentation group and 12.6° in the posterior instrumentation group (p < 0.01). The correction loss was 6.8° in the anterior instrumentation group and 6.1° in the posterior instrumentation group at the last follow-up (p < 0.01).
  
  
  CONCLUSIONS
  The four surgical procedures obtained good results for correction and maintenance of the correction, clearance of the foci, decompression of the spinal cord and pain relief in the treatment of spinal TB in adults, providing that the operative indication is accurately identified. However, the posterior approach was superior to anterior instrumentation for correcting deformity and maintaining the correction.
authors: Department of Orthopedics, 309th Hospital of PLA, Beijing, China. cuixuprossor@163.com
authors: Xu
authors: X
authors: Cui
authors: Yuan Zheng
authors: YZ
authors: Ma
authors: Xing
authors: X
authors: Chen
authors: Xiao Jun
authors: XJ
authors: Cai
authors: Hong Wei
authors: HW
authors: Li
authors: Yi Bing
authors: YB
authors: Bai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D003646:Debridement; D019299:Decompression, Surgical; D004185:Disability Evaluation; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000382:microbiology / Q000601:surgery; D008875:Middle Aged; D019635:Neurosurgical Procedures; D016348:Osseointegration; D010146:Pain / Q000601:surgery; D063868:Patient Outcome Assessment; D013123:Spinal Fusion; D014399:Tuberculosis, Spinal / Q000601:surgery*; D055815:Young Adult
references: Med Princ Pract. 2010;19(6):451-6
references: 20881412
references: J Spinal Disord Tech. 2009 Jun;22(4):257-62
references: 19494745
references: Spine (Phila Pa 1976). 1995 Sep 1;20(17):1910-6
references: 8560340
references: J Spinal Disord Tech. 2007 May;20(3):209-15
references: 17473640
references: Clin Orthop Relat Res. 2006 Mar;444:100-6
references: 16523133
references: Eur Spine J. 2003 Apr;12(2):224-34
references: 12709862
references: J Spinal Disord Tech. 2006 Dec;19(8):554-9
references: 17146297
references: Spine (Phila Pa 1976). 1994 May 1;19(9):1039-43
references: 8029738
references: J Bone Joint Surg Br. 2003 Jan;85(1):100-6
references: 12585586
references: Int Orthop. 2009 Oct;33(5):1385-90
references: 19340427
references: Eur Spine J. 2004 Mar;13(2):114-21
references: 14685831
references: J Bone Joint Surg Br. 2010 Jul;92(7):905-13
references: 20595106
references: J Spinal Disord Tech. 2006 Dec;19(8):595-602
references: 17146304
references: Int Orthop. 2010 Mar;34(3):395-9
references: 19277654
references: Clin Orthop Relat Res. 2002 May;(398):50-9
references: 11964631