A Comparative Study of Anterior and Posterior Tuberculosis Lesions for the Treatment of Thoracolumbar Tuberculosis disease: A Single Institution Experience in a Major Academic Hospital.

Objective: To compare the efficacy of anterior and posterior surgery for thoracolumbar tuberculosis disease.

Methods: Clinical data of 30 patients with thoracolumbar tuberculosis disease undergoing anterior and posterior surgery from January 2021 to December 2023 were collected for a retrospective study. According to the two surgical procedures, patients were divided into two groups: 1) anterior group (n=15) and 2) posterior group (n=15). We compared the two groups regarding age, gender, body mass index, affected segments, past history (cardiovascular and cerebrovascular diseases, respiratory diseases, endocrine system diseases, metabolic diseases, and tuberculosis history), smoking history, drinking history, operation time, postoperative bleeding, postoperative drainage, postoperative time, postoperative complications (dural tear, lower limb intermuscular vein thrombosis, lower limb deep vein thrombosis, sinus infection, postoperative recurrence rate), and waist VAS score before and after surgery, waist ODI score, and JOA score.

Results: The intraoperative blood loss was significantly less in the posterior group than in the anterior group, and the difference was significant (P <0.05); the lumbar VAS score was lower in the posterior group than in the anterior group, and the difference between the two groups was significant (P <0.05). The analysis of the remaining data showed no significant difference between the two groups (P> 0.05), indicating that the efficacy of the two procedures was the same.

Conclusion: In the treatment of thoracolumbar tuberculosis disease, there is no significant difference in the clinical efficacy of anterior surgery and posterior surgery. Intraoperative bleeding in posterior surgery was less than in anterior surgery, but the latter showed a significant improvement in postoperative pain relief. Therefore, spinal surgeons should choose the corresponding surgical treatment according to the actual situation of the patient in order to maximize the efficacy.