Single-Stage Posterior Instrumentation and Unilateral Transpedicular Debridement for the Treatment of Thoracolumbar Tuberculosis: Three Years of Follow-Up.

OBJECTIVE

The present study compared the efficacy and safety of single-stage posterior instrumentation and unilateral transpedicular debridement with the traditional posterior operation for the treatment of thoracolumbar tuberculosis.

METHODS

Of the 97 included patients, 53 had undergone posterior unilateral transpedicular debridement and pedicle screw fixation (group A) and 44 had undergone the traditional posterior operation (group B). We compared the outcomes, including correction of kyphosis (Cobb angle), bone fusion rate, visual analog scale score, Frankel classification, and short-form 12-item health survey between the 2 groups.

RESULTS

All patients obtained intervertebral bone fusion. The mean interval to bone graft fusion was 4.1 months (range, 3-8 months). The patients in the 2 groups showed significant improvement in kyphosis correction, short-form 12-item health survey score, and nerve function. In addition, single-stage posterior instrumentation and unilateral transpedicular debridement resulted in comparable clinical outcomes for the treatment of thoracolumbar tuberculosis. However, the patients experienced less trauma, greater spinal stability, and better functional recovery compared with the traditional posterior operation group.

CONCLUSIONS

Our results suggest that single-stage posterior instrumentation and unilateral transpedicular debridement can be considered an effective and safe therapy for spinal tuberculosis with single-level and/or bi-level segments.