[Objective]To compare the clinical outcomes of anterior versus posterior approach debridement and instrumented fusions for thoracolumbar tuberculosis.[Methods]A retrospective study was performed on 103 patients who received surgical treatment for thoraco-lumbar tuberculosis in our hospital from January 2015 to October 2020.According to doctor-patient communication,39 patients underwent anterior-approach surgery(the anterior group),while the remaining 64 cases underwent posterior-approach surgery(the posterior group).The perioperative,follow-up and imaging data of the two groups were compared.[Results]All patients in both groups had corresponding sur-gical procedures performed successfully,the anterior group proved significantly greater than the posterior group in terms of operation time[(136.7±19.2)min vs(108.7±15.6)min,P＜0.05],the total incision length[(23.0±3.8)cm vs(14.6±3.5)cm,P＜0.05],intraoperative blood loss[(558.7±42.7)ml vs(408.8±35.8)ml,P＜0.05],regardless of the fact thar the former had significantly less intraoperative fluoroscopy times than the latter[(3.5±1.5)times vs(6.7±2.1)times,P＜0.05].In addition,the incidence of early complications in the anterior group was signifi-cantly higher than that in the posterior group(15.4％vs 6.3％,P＜0.05).The follow-up period lasted for a mean of(29.6±10.4)months,and there was no significant difference in clinical healing time between the two groups(P＞0.05).The VAS,ODI and JOA scores were significant-ly improved in 2 groups(P＜0.05),while ASIA grade for neurological function remained unchanged over time in both groups(P＞0.05),which were not statistically significant between the two groups at any time points accordingly(P＞0.05).With respect of imaging,the spinal canal ar-ea,local kyphotic Cobb angle and lesion state were significantly improved in both groups at the last follow-up compared with those preopera-tively(P＜0.05),whereas all which were not statistically significant between the two groups at any time points accordingly(P＞0.05).[Conclu-sion]Both anterior and posterior debridement and instrumented fusions are effective options for the treatment of thoracolumbar tuberculosis,by comparison,the posterior surgery has certain advantages of less trauma over the anterior counterpart.
spinal tuberculosisspinal nerve injuryanterior surgeryposterior surgery
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