Single-stage posterior-only approach treating single-segment thoracic tubercular spondylitis

Area of Science:

• Orthopedics
• Neurosurgery
• Infectious Diseases

Background:

• Surgical management of single-segment thoracic spinal tuberculosis (STB) with neurological deficits remains controversial.
• Evaluating minimally invasive techniques is crucial for improving patient outcomes.

Purpose of the Study:

• To compare single-stage posterior-only surgery with combined posterior-anterior surgery for STB with neurological deficits.
• To determine the clinical feasibility and effectiveness of the posterior-only approach.

Main Methods:

• Sixty patients with single-segment thoracic STB and neurological deficits were divided into two groups: posterior-only surgery (30 patients) and combined posterior-anterior surgery (30 patients).
• Outcomes assessed included neurological recovery (ASIA score), pain (VAS), TB activity (ESR, CRP), surgical duration, blood loss, hospitalization, fusion rates, and kyphosis correction.

Main Results:

• All patients showed neurological improvement. STB was cured with bone fusion in all cases within 5-11 months.
• The posterior-only surgery group demonstrated significantly lower operative duration, blood loss, length of hospital stay, and complication rates.
• No significant differences in radiological results or recurrent infections were observed between the groups.

Conclusions:

• Single-stage posterior-only surgery is a feasible and effective treatment for single-segment thoracic spinal tuberculosis with neurological deficits.
• The posterior-only approach yields superior clinical outcomes, particularly regarding reduced surgical invasiveness and faster recovery.
• This technique offers a promising alternative to combined approaches for selected STB patients.