Surgical Treatment of Thoracic Spinal Tuberculosis: A Multicenter Retrospective Study

Area of Science:

• Orthopedics
• Neurosurgery
• Infectious Diseases

Background:

• Thoracic tuberculosis presents complex surgical challenges.
• Evaluating different surgical strategies is crucial for optimal patient outcomes.

Purpose of the Study:

• To assess the safety and effectiveness of various surgical approaches for thoracic tuberculosis.
• To provide a reference for surgical treatment decisions in thoracic tuberculosis.

Main Methods:

• Retrospective review of 394 patients with thoracic tuberculosis treated between 2000 and 2015.
• Categorization of patients into three groups: one-stage anterior surgery, anterior combined posterior surgery, and one-stage posterior surgery.
• Analysis of clinical outcomes, laboratory data, and radiological results, focusing on the advantages of the posterior approach.

Main Results:

• All patients achieved bone fusion, pain relief, and neurological recovery at follow-up (average 37 months).
• Significant improvements were observed in Visual Analog Scale and Oswestry Disability Index scores post-treatment (P < 0.05).
• The posterior approach demonstrated significant improvement in kyphosis correction (P < 0.05).

Conclusions:

• Posterior fixation excels in correcting kyphosis and maintaining spinal stability compared to anterior fixation.
• One-stage posterior surgery is as effective as anterior or combined approaches, with reduced trauma, blood loss, and operative time.
• The anterior combined posterior approach remains essential for extensive lesions, severe bone destruction, and large anterior/middle column defects requiring extensive grafting.