A comparative study of single-stage transpedicular debridement, fusion, and posterior long-segment versus short-segment fixation for the treatment of thoracolumbar spinal tuberculosis in adults: minimum five year follow-up outcomes
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This a retrospective study in single centre.
The objective of this retrospective clinical study is to compare the long-term clinical efficacy of posterior long-segment and short-segment fixation with single-stage transpedicular debridement and fusion for the treatment of thoracolumbar spinal tuberculosis in adults.
Sixty-six cases of thoracolumbar tuberculosis were treated by single-stage transpedicular debridement, bone graft fusion, and pedicle screw fixation. Thirty-five cases were under long-segment fixation (group A) and 31 cases were under short-segment fixation (group B). These patients were followed up for a minimum of five years. The clinical and radiographic results for these patients were analyzed and compared.
All 66 patients were completely cured during the follow-up. All patients had significant improvement of neurological condition and visual analogue scale pain scores at the final follow-up. The average operation duration and blood loss in group A were more than that in group B. Kyphosis Cobb angle of both groups was significantly corrected after surgical management. The correction rate of Cobb angle in group A was significantly higher than that in group B at the time of immediate post-operative period or the last follow-up (P < 0.05). The correction loss of group A was significantly less than that in group B (P < 0.05).
Both posterior long-segment and short-segment pedicle screw fixations for the treatment of thoracolumbar spinal tuberculosis have significant effects in the correction of kyphosis and the improvement of neurological function. Although the blood loss and operation time of long-segment fixation were more than that of short-segment fixation, long-segment fixation was superior to the short-segment fixation in the correction of kyphosis and the maintenance of spinal stability, especially in the prevention of long-term correction loss.
KeywordsLong-segment fixation Short-segment fixation Thoracolumbar spinal tuberculosis
The work was supported by the National Natural Science Foundation of China (No.81672191) and clinical scientific research funds of Xiangya Hospital (2016L07). No benefit in any form has been or will be received from a commercial party related directly or indirectly to the subject of this manuscript
Compliance with ethical standards
Conflict of interest
The authors declare that there is no conflict of interest.
- 1.Organization WH. (2016). Global tuberculosis report 2016. Global Tuberculosis Report 6(2)Google Scholar
- 9.Zhang P, Wei P, Wang X, Luo C, Xu Z, Hao Z, Zheng L, Zhang Y, Lei G (2016) Minimum 5-year follow-up outcomes for single-stage transpedicular debridement, posterior instrumentation and fusion in the management of thoracic and thoracolumbar spinal tuberculosis in adults. Br J Neurosurg 30(6):1–6Google Scholar
- 10.Wang B, Lv G, Liu W, Cheng I (2010) Anterior radical debridement and reconstruction using titanium mesh cage for the surgical treatment of thoracic and thoracolumbar spinal tuberculosis: minimum five-year follow-up. Turkish Neurosurg 21(4):575–581Google Scholar
- 23.Yong-Gang WU (2005) The expression of BMP-2/4 in the focus of spinal tuberculosis. Ningxia Med J 2005Google Scholar