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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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Abstract

Design

This a retrospective study in single centre.

Objective

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.

Methods

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.

Results

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).

Conclusion

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.

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Funding

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

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Authors and Affiliations

  1. Department of Spine Surgery, Xiangya Hospital, Central South University, 87#Xiangya Road, Changsha, 410008, Hunan, People’s Republic of China

    Zheng Liu & Xiyang Wang

  2. Hunan Engineering Laboratory of Advanced Artificial Osteo-Materials, 87#Xiangya Road, Changsha, 410008, Hunan, People’s Republic of China

    Zheng Liu & Xiyang Wang

  3. The Orthopedics Department, The Seventh Affiliated Hospital, Sun Yat-sen University, 628#Zhenyuan Road, Zhenmei Community, Guangming District, Shenzhen, 518107, Guangdong, People’s Republic of China

    Penghui Zhang

  4. The Department of Spine and Osteopathia Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530022, Guangxi, People’s Republic of China

    Hao Zeng

  5. The Orthopedics Department, The First Affiliated Hospital, Fujian Medical University, Fuzhou, 350004, Fujian, People’s Republic of China

    Zhengquan Xu

Authors
  1. Zheng Liu
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  2. Penghui Zhang
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  3. Hao Zeng
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  4. Zhengquan Xu
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  5. Xiyang Wang
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Corresponding author

Correspondence to Xiyang Wang.

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Liu, Z., Zhang, P., Zeng, H. et al. 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. International Orthopaedics (SICOT) 42, 1883–1890 (2018). https://doi.org/10.1007/s00264-018-3807-0

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  • DOI: https://doi.org/10.1007/s00264-018-3807-0

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