Posterior-only vs. combined posterior-anterior approaches in treating lumbar and lumbosacral spinal tuberculosis: a retrospective study with minimum 7-year follow-up
Abstract Background There is no comparative study with long-term follow-up between posterior-only and combined posterior-anterior approaches in treating lumbar spinal tuberculosis (LSTB) and lumbosacral spinal tuberculosis (LSSTB). This retrospective study aimed to compare and evaluate the long-term...
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | Journal of Orthopaedic Surgery and Research |
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| Online Access: | http://link.springer.com/article/10.1186/s13018-020-01616-7 |
| _version_ | 1811185243297677312 |
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| author | Zheng Liu Penghui Zhang Weiwei Li Zhengchao Xu Xiyang Wang |
| author_facet | Zheng Liu Penghui Zhang Weiwei Li Zhengchao Xu Xiyang Wang |
| author_sort | Zheng Liu |
| collection | DOAJ |
| description | Abstract Background There is no comparative study with long-term follow-up between posterior-only and combined posterior-anterior approaches in treating lumbar spinal tuberculosis (LSTB) and lumbosacral spinal tuberculosis (LSSTB). This retrospective study aimed to compare and evaluate the long-term outcomes of these two surgical approaches in LSTB and LSSTB. Methods Thirty patients with LSTB and 12 patients with LSSTB underwent posterior-only approach (group A); 26 patients with LSTB and 14 patients with LSSTB were managed with combined posterior-anterior approaches (group B). Analysis and comparison in clinical and radiographic outcomes between the two groups were performed. Results The intra-operative bleeding amount, surgery time, and hospitalization days in group A were less than that in group B (P < 0.05). These patients were followed for a minimum of 7 years. All patients achieved completely healing within 2-year follow-up. Bony fusion was obtained in all patients. The visual analog scale, Japanese Orthopedic Association score, Oswestry Disability index, and Kirkaldy-Willis functional evaluation at the final visit demonstrated that all patients in both groups achieved satisfactory results. There was no significant difference in angle correction or maintaining correction between combined posterior-anterior approaches and posterior-only approach (P > 0.05). Complications occurred in both groups. Conclusions Both combined posterior-anterior approaches and posterior-only approach can achieve satisfactory clinical and radiological outcomes of long-term in treating LSTB and LSSTB, while posterior-only approach can safely and effectively achieve lesion debridement, decompression, and stability reconstruction and maintenance with the advantages of less invasive surgery, less bleeding, shorter surgery time, and hospital stay, and fewer complications. So, posterior-only approach seemed to be superior to the combined posterior-anterior one. |
| first_indexed | 2024-04-11T13:26:11Z |
| format | Article |
| id | doaj.art-e21b77796e9341549d65804f3072cd61 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-11T13:26:11Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-e21b77796e9341549d65804f3072cd612022-12-22T04:22:03ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2020-03-0115111110.1186/s13018-020-01616-7Posterior-only vs. combined posterior-anterior approaches in treating lumbar and lumbosacral spinal tuberculosis: a retrospective study with minimum 7-year follow-upZheng Liu0Penghui Zhang1Weiwei Li2Zhengchao Xu3Xiyang Wang4Department of Spine Surgery, Xiangya Hospital, Central South UniversityThe Orthopedics Department, the Seventh Affiliated Hospital, Sun Yat-sen UniversityDepartment of Spine Surgery, Xiangya Hospital, Central South UniversityDepartment of Spine Surgery, Xiangya Hospital, Central South UniversityDepartment of Spine Surgery, Xiangya Hospital, Central South UniversityAbstract Background There is no comparative study with long-term follow-up between posterior-only and combined posterior-anterior approaches in treating lumbar spinal tuberculosis (LSTB) and lumbosacral spinal tuberculosis (LSSTB). This retrospective study aimed to compare and evaluate the long-term outcomes of these two surgical approaches in LSTB and LSSTB. Methods Thirty patients with LSTB and 12 patients with LSSTB underwent posterior-only approach (group A); 26 patients with LSTB and 14 patients with LSSTB were managed with combined posterior-anterior approaches (group B). Analysis and comparison in clinical and radiographic outcomes between the two groups were performed. Results The intra-operative bleeding amount, surgery time, and hospitalization days in group A were less than that in group B (P < 0.05). These patients were followed for a minimum of 7 years. All patients achieved completely healing within 2-year follow-up. Bony fusion was obtained in all patients. The visual analog scale, Japanese Orthopedic Association score, Oswestry Disability index, and Kirkaldy-Willis functional evaluation at the final visit demonstrated that all patients in both groups achieved satisfactory results. There was no significant difference in angle correction or maintaining correction between combined posterior-anterior approaches and posterior-only approach (P > 0.05). Complications occurred in both groups. Conclusions Both combined posterior-anterior approaches and posterior-only approach can achieve satisfactory clinical and radiological outcomes of long-term in treating LSTB and LSSTB, while posterior-only approach can safely and effectively achieve lesion debridement, decompression, and stability reconstruction and maintenance with the advantages of less invasive surgery, less bleeding, shorter surgery time, and hospital stay, and fewer complications. So, posterior-only approach seemed to be superior to the combined posterior-anterior one.http://link.springer.com/article/10.1186/s13018-020-01616-7Lumbar spinal tuberculosisLumbosacral spinal tuberculosisPosterior-only approachCombined posterior-anterior approachesLong-term follow-up |
| spellingShingle | Zheng Liu Penghui Zhang Weiwei Li Zhengchao Xu Xiyang Wang Posterior-only vs. combined posterior-anterior approaches in treating lumbar and lumbosacral spinal tuberculosis: a retrospective study with minimum 7-year follow-up Journal of Orthopaedic Surgery and Research Lumbar spinal tuberculosis Lumbosacral spinal tuberculosis Posterior-only approach Combined posterior-anterior approaches Long-term follow-up |
| title | Posterior-only vs. combined posterior-anterior approaches in treating lumbar and lumbosacral spinal tuberculosis: a retrospective study with minimum 7-year follow-up |
| title_full | Posterior-only vs. combined posterior-anterior approaches in treating lumbar and lumbosacral spinal tuberculosis: a retrospective study with minimum 7-year follow-up |
| title_fullStr | Posterior-only vs. combined posterior-anterior approaches in treating lumbar and lumbosacral spinal tuberculosis: a retrospective study with minimum 7-year follow-up |
| title_full_unstemmed | Posterior-only vs. combined posterior-anterior approaches in treating lumbar and lumbosacral spinal tuberculosis: a retrospective study with minimum 7-year follow-up |
| title_short | Posterior-only vs. combined posterior-anterior approaches in treating lumbar and lumbosacral spinal tuberculosis: a retrospective study with minimum 7-year follow-up |
| title_sort | posterior only vs combined posterior anterior approaches in treating lumbar and lumbosacral spinal tuberculosis a retrospective study with minimum 7 year follow up |
| topic | Lumbar spinal tuberculosis Lumbosacral spinal tuberculosis Posterior-only approach Combined posterior-anterior approaches Long-term follow-up |
| url | http://link.springer.com/article/10.1186/s13018-020-01616-7 |
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