| Objective:To compare the therapeutic effects of posterior surgery and one-stage combined anterior-posterior surgery for the treatment thoracic and lumbar tuberculosis in a single institute,investigate the indications,advantages and disadvantages of the two types of treatments for thoracic and lumbar tuberculosis and asses the feasibilty of posterior surgery in the treatment of thoracic and lumbar spinal tuberculosis.Methods:From May 2004 to October 2008,20 patients in group 1 aged from21 to 78 with thoracic and lumbar spinal tuberculosis were treated with posterior surgical procedure alone,the disease course ranged from 0.5 to 36 months and the number of affected vertebral body were 2-3.19 patients in group 2 aged from 19 to 76 with thoracic and lumbar spinal tuberculosis were treated with one-stage combined anterior-posterior surgery,the disease course ranged from 0.75 to 96 months and the number of affected vertebral body were 2-5.All patients were managed by standard course of chemotherapy.The perioperative indicators,clinical symptoms, complications,laboratory and image indicators in the two groups were compared.All patients were followed and the duration of follow-up ranged from 6 months to 57 months.Results:Spinal tuberculosis was completely cured and all patients had complete fusion.The visual analog scale and ASIA grade improved in all cases.There was no persistence or recurrence of tuberculosis.The kyphosis was significantly corrected after surgical management and the loss of correction was not significant in both groups.But there were statistical differences in two groups with respect to the operation time,the hemorrhage and blood transfusion quantity,the amount of drainage and the length of stay.Conclusions:The posterior surgical procedure with instrumentation shows a less operative trauma and it can be an alternative treatment method for thoracic and lumbar tuberculosis. |
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