Surgery for thoracolumbar junction (T12-L1) tuberculosis a multicentre, retrospective study
Abstract Purpose A multicentre, retrospective study was conducted to evaluate the safety and efficacy of different surgical techniques for thoracolumbar junction (T12-L1) tuberculosis. Methods The medical records of thoracolumbar junction tuberculosis patients (n = 257) from January 2005 to January 2015 were collected and reviewed. A total of 45 patients were operated on by an anterior approach (Group A), 52 by a combined anterior and posterior approach (Group B) and 160 by a posterior approach (Group C). Anti-tuberculosis therapy was performed both before and after surgery. Clinical outcomes, laboratory indexes and radiological results of the three groups were compared. Results All three surgical approaches achieved bone fusion, pain relief and neurological recovery. The mean loss of correction in group A at last follow-up was higher than in groups B and C (P < 0.05), and the difference between groups B and C was not significant (P > 0.05). The mean operation time and blood loss in group B were greater than in groups A and C. Conclusions For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only approach is superior to the anterior-only approach in the correction of kyphosis and maintenance of spinal stability. The posterior-only approach is recommended because it achieves the same efficacy as the anterior-only or combined approach but with shorter operation times, less trauma and less blood loss. Keywords Spinal tuberculosis; Thoracolumbar junction; Three approaches.