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Study on anterior and posterior approaches for spinal tuberculosis: a meta-analysis

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Timely and appropriate surgical intervention can enhance the stability of spine, eliminate the compression on spinal cord and prevent the further development the complications that may follow. However, there is no optimum surgical approach that has been agreed by surgeons.

Objective

Incidence rate of spinal tuberculosis is still high in many developing countries. Except from chemotherapy, some patients require surgical treatment at certain phases of disease development. However, there is still not a standard operative procedure for spinal tuberculosis in the current research, and we studied the differences of anterior and posterior approach for spinal tuberculosis, to provide guidance for the further operative treatments.

Methods

We searched “Pubmed” (2000.1–2014.7), “Medline” (2000.1–2014.7), “Elseveir” (2000.1–2014.7), Cochrane library (2008.1–2014.7), Wanfang (2000.1–2014.7), and CNKI (2000.1–2014.7) databases with the key words of “thoracolumbar tuberculosis”, “controlled randomized trial”, “RCT”, “anterior” “posterior”, and searched for randomized controlled trials for spinal tuberculosis. We compared the operative time, total blood loss, correction of Cobb angle, loss of Cobb angle at final follow-up, fusion time of allograft, time of total hospital stay, and the effectiveness of operative treatment between the anterior and posterior surgical approaches by Revman5.3 software.

Results

From 1,523 papers found, we chose eight randomized controlled trials comparing different surgical approaches for the treatment of spinal tuberculosis. The total number of patients was 754, in which 377 were treated with anterior approach and 377 were treated with posterior approach correction of Cobb angle (P < 0.05), and no significant differences were found regarding operation time, loss of correction of Cobb angle in the last follow-up, time of total hospital stay, and fusion time of bone graft (P > 0.05).

Conclusions

There are significant differences between the two operative approaches regarding the correction of Cobb angle, but no significant differences regarding operation time, blood loss, loss of Cobb angle at the last follow-up, total fusion time, and length of total stay in the hospital.

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Conflict of interest

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Authors and Affiliations

  1. Department of Orthopedic Oncology Surgery, Beijing Ji Shui Tan Hospital, 31 Xinjiekou East Street, Xicheng District, Beijing, 100035, People’s Republic of China

    Aikeremujiang Muheremu & Xiaohui Niu

  2. Department of Orthopedics, Fifth Affiliated Hospital of Xinjiang Medical University, No 118, West Henan Road, Xinshi District, Ürümqi, 830010, Xinjiang, People’s Republic of China

    Zhongyan Wu

  3. Department of Spine Surgery, Beijing Ji Shui Tan Hospital, 31 Xinjiekou East Street, Xicheng District, Beijing, 100035, People’s Republic of China

    Wei Tian

Authors
  1. Aikeremujiang Muheremu
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  2. Xiaohui Niu
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  4. Wei Tian
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Correspondence to Wei Tian.

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Muheremu, A., Niu, X., Wu, Z. et al. Study on anterior and posterior approaches for spinal tuberculosis: a meta-analysis. Eur J Orthop Surg Traumatol 25 (Suppl 1), 69–76 (2015). https://doi.org/10.1007/s00590-014-1508-y

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  • DOI: https://doi.org/10.1007/s00590-014-1508-y

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