Posterior Approach Alone Versus Combined Anterior and Posterior Approach in the Management of Vertebral Tuberculosis

Turk Neurosurg. 2019;29(5):724-733. doi: 10.5137/1019-5149.JTN.25968-19.3.


Aim: To compare posterior surgery alone versus combined anterior and posterior surgery for the management of spinal tuberculosis.

Material and methods: Data from 31 consecutive patients who underwent surgery for spinal tuberculosis were analyzed retrospectively. Patients were divided into two groups as group A (posterior surgery alone) or group B (combined anterior and posterior surgery), and groups were compared in terms of invasiveness of the procedure, spinal deformity, fusion, neurological status, and postoperative complications.

Results: Group A included 16 patients (mean age: 56 years, range: 29-75) with a mean follow-up period of 29 months (range 12-60) while group B included 15 patients (mean age: 60 years, range: 35-73) with a mean follow-up period of 28 months (range 12-60). Procedurally, average operation time and mean length of hospitalization were shorter, and mean blood loss was lower in group A (p < 0.05) compared to group B. Postoperative bone fusion took significantly (p < 0.05) longer time in group A (10.5 ± 2.1 months)than in group B (9.3 ± 3.1 months), and all patients with a neurological deficit recovered completely during the postoperative period. No significant differences were observed between two groups with respect to postoperative complications (p > 0.05).

Conclusion: Combined anterior-posterior surgery may not be required for treating vertebral tuberculosis as posterior surgery alone appears to be sufficient.

MeSH terms

  • Adult
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures / methods*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Period
  • Retrospective Studies
  • Spinal Fusion / methods*
  • Thoracic Vertebrae / surgery
  • Treatment Outcome
  • Tuberculosis, Spinal / surgery*