Anterior Versus Posterior Approaches For Surgical Treatment Of Spinal Tuberculosds:A Meta-Analysis

Objectives:To evaluate the clinical out-comes after anterior approach surgery and posterior approach surgery for the treatment of spinal tuberculosis by making a meta—analysis.MethodsThe databases are retrieved by computer.The Chinese database includes: SinoMed,CNKI,Wanfang Database,and VIP;foreign language databases are: PubMed,Web of Science,;the time limit is set to build the library until March 2019,and manually searching related magazines.Retrieving literature on the use of anterior and posterior surgical approaches for the treatment of spinal tuberculosis,screening all results in strict accordance with inclusion and exclusion criteria,obtaining eligible controlled studies,and evaluating the quality of the literature.literature-related data were extracted,and all the extracted data were subjected to Meta-analysis using RevMan 5.3.The evaluation indexes of the retrieved literature in this study include: operation time;intraoperative blood loss;hospitalization time;kyphosis correction rate;The correction degree of kyphosis cobb angle;bone fusion time;kyphosis Cobb angle loss at final follow-up;complications.Results:14 studies involving 970 patients were included,anterior approach group including 447 patients,posterior approach group including 567 patients,comparing two groups of evaluation indicators,the results of the meta-analyses showed that the group of anterior approach have advantage in operation time [MD=22.14,95%CI(7.88,36.40),P=0.002?blood loss[MD=121.24,95%CI(7.88,234.61),P=0.04]?kyphosis correction rate [MD=-11.91,95%CI(-21.24,-2.58),P=0.01],kyphosis cobb correction degree [MD=-5.23,95%CI(-8.42,-2.03),P=0.001],bone fusion time [MD=0.28,95%CI(0.06,0.51),P=0.01],and the loss of kyphosis correction at the final follow-up [MD=3.24,,95%CI(1.22,5.27),P=0.002] to the posterior approach group.There was no statistically significant difference in hospital stay[MD=1.24,95%CI(-0.51,2.99),P=0.16]between two groups.Conclusion:The posterior approach surgery group was superior to the anterior surgery group in terms of operative time,intraoperative blood loss,kyphosis cobb correction,kyphosis correction,bony fusion time,and the loss of kyphosis correction at the last follow-up.There was no statistically significant difference in the length of hospital stay between the anterior and posterior surgery groups.