Comparison between the antero-posterior and posterior only approaches for treating thoracolumbar tub

• 作 者: Xin Hua Yin Zhen Hai Zhou Hong Gui Yu Xiong Ke Hu Qiang Guo Hong Qi Zhang
• 机 构: Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Xi'
• 出 处: 第三届全国脊柱结核诊疗新技术研讨会暨2017年湖南省医学会脊柱外科专业委员会年会
• 发表日期: 2017年8期
• 关键词: Children Thoracolumbar tuberculosis Antero-posterior Posterior-only

　　Purpose There are few papers in the literature comparing out-comes between antero-posterior and posterior-only ap-proaches for treating thoracolumbar tuberculosis (T10-L2) in children Methods We performed a retrospective review of 47 children who were diagnosed and treated as thoracolumbar tuberculo-sis (T10-L2) in our department from January 2005 to June 2009.Forty-seven cases of thoracolumbar tuberculosis were treated by two different surgical approaches.All the cases were divided into two groups: 25 cases in group A underwent one-stage posterior debridement,transforaminal fusion,and instrumentation,and 22 cases in group B underwent anterior debridement,bone graft,and posterior in-strumentation in a single-or two-stage procedure.Two ap-proaches were compared in terms of average operative time,blood loss,hospitalizations,bony fusion,intraoperative and postoperative complications,the Oswestry disability index score,neurological status,and the angle of kyphosis.Results All 47 patients (24 M/23F),averaged 9.1 ±2.6 years old (range 5 to 14 years),who were followed up for mean of 49.3±8.6 months (range 36 to 65 months).Spinal tuberculosis (TB) was completely cured,and the grafted bones were fused in 9 months in all cases.It was obviously that the average operative time,blood loss,hospitalization,and complication rate of group A was less than those of group B.Good clinical outcomes were achieved in both groups.Conclusions Both the antero-posterior and posterior approaches can effectively heal T10-L2 vertebral tuberculosis,but the aver-age surgical time,blood loss,complications,and hospital stay following the posterior approach are prominently less than those following the antero-posterior approach.It might be a better sur-gical treatment for thoracic spinal tuberculosis in children with poor health status,especially for cases in early phase of bone destruction and/or mild and moderate kyphosis.