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Osteotomized debridement versus curetted debridement in posterior approach in treating thoracolumbar tuberculosis: a comparative study

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Abstract

Purpose

This study aimed to compare osteotomized debridement (OD) with traditional curetted debridement (CD) in treating thoracolumbar tuberculosis (TB).

Methods

A total of 188 patients were diagnosed with active thoracolumbar TB and underwent one-stage posterior surgery at our institution. Of the 188 patients, 85 patients were treated with OD, and 103 patients were treated with traditional CD. The patient information, laboratory results, imaging findings, and clinical effectiveness were, respectively, compared between the two groups.

Results

Group OD consumed less operation time and blood loss than group CD (P < 0.05 for both values). No significant difference in hospitalization time was found between the two groups (P > 0.05). The values of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in both groups returned to the normal range within one month postoperatively. All patients had significant improvement in visual analog scale (VAS) and oswestry disability index (ODI) postoperatively. The mean fusion time in group OD was shorter than that in group CD (P < 0.05). There was no statistically significant difference in preoperative kyphotic angle between the two groups (P > 0.05), but group OD showed less correction loss than group CD at the final follow-up (P < 0.05). The rate of recurrence and surgery-related complications in group OD was lower than group CD.

Conclusions

Posterior OD, reconstruction with titanium mesh cages (TMCs), and instrumentation is feasible and effective in treating thoracolumbar TB. Compared with the traditional CD, OD can achieve radical lesion removal, more effective kyphosis correction, lower recurrence rate, and fewer complications.

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Data availability

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

The authors did not receive support from any organization for the submitted work.

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Author notes

  1. Shengbiao Ma, Zhenghai Zhou and Zongmiao Wan contributed equally to this work.

Authors and Affiliations

  1. The Orthopedic Hospital, The First Affiliated Hospital of Nanchang University, No. 1519 Dongyue Road, Nanchang, 330006, Jiangxi, China

    Shengbiao Ma, Zhenghai Zhou, Zongmiao Wan, Pingguo Duan, Sheng Huang, Jiang Xu, Wenqiang Deng, Chunyang Wu & Kai Cao

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  1. Shengbiao Ma
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  2. Zhenghai Zhou
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Contributions

Conceptualization: KC. Methodology: KC, SM. Formal analysis and investigation: ZZ, JX. Writing—original draft preparation: SM, CW. Writing—review and editing: ZZ, PD. Resources: SM, SH, WD. Supervision: ZW.

Corresponding author

Correspondence to Kai Cao.

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There are no conflicts of interest for this manuscript, and the authors have no relevant financial or non-financial interests to disclose.

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The data does not compromise anonymity or confidentiality or breach local data protection laws, and it is approved by The Affiliated Hospital of Nanchang University for publication.

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Ma, S., Zhou, Z., Wan, Z. et al. Osteotomized debridement versus curetted debridement in posterior approach in treating thoracolumbar tuberculosis: a comparative study. Eur Spine J 31, 473–481 (2022). https://doi.org/10.1007/s00586-021-07075-w

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  • DOI: https://doi.org/10.1007/s00586-021-07075-w

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