Posterior-only stabilization versus global reconstruction in thoracic and thoracolumbar spinal tuberculosis; a prospective randomized study
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OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2022;10(10):40 Int Orthop . 2022 Mar;46(3):597-603.What this means for my practice?
Posterior-only or global reconstruction, represent effective management of spinal tuberculosis disease affecting thoracic and thoracolumbar vertebrae. The results of this trial suggest that clinical, functional, and radiological outcomes were comparable. The results of the current trial are limited by a single-centre design and sample size.
Study Summary
Fifty-eight patients with thoracic or thoracic-lumbar spinal tuberculosis with borderline anterior vertebral defects were randomized to undergo either posterior stabilization (n=29) or global reconstruction (n=29). All patients received anti-TB chemotherapy. The primary outcomes were clinical (including neurological), radiological, and functional outcomes. There were no differences in clinical (including neurological), functional [Visual Analog Scale (VAS) & Oswestry Disability Index (ODI) scores], and radiological outcomes (Cobb's angle, kyphosis correction, loss of correction, angle loss rate, & fusion time) between the two groups. No differences in complications were noted.
Why was this study needed now?
Although the guidelines for surgical indications in spinal tuberculosis (TB) are well-established, ambiguity still exists in deciding between posterior-only stabilization and global reconstruction in patients with thoracic and thoracolumbar disease with borderline vertebral destruction. Therefore, a trial to compare the safety and efficacy of these two surgical interventions was needed.
What was the principal research question?
In a population of thoracic and thoracic-lumbar (TL) spinal tuberculosis (TB) patients with a borderline anterior vertebral defect, are clinical, radiological, and functional outcomes similar or different among posterior-only stabilization versus global reconstruction?
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