Purpose The aim of this study is to compare the clinical,
radiological and functional outcome of anterior versus
posterior surgical debridement and fixation in patients with
thoracic and lumbar tuberculous spondylodiscitis.
Patients and methods A total number of 42 patients with
tuberculous spondylodiscitis of the thoracic and lumbar spine
treated surgicallywere included in this study.Twenty patients
(group A) underwent anterior debridement, decompression
and instrumentation by anterior approach. Twenty-two
patients (group B) were operated by posterolateral (extracavitary)
decompression and posterior instrumentation.
Operative parameters, clinical, radiographic and functional
results for the two groups were analyzed and compared.
Results The average follow-up period was 15 months
(range 12–24) in both groups. The average operative time,
blood loss and blood transfusion of anterior group were
significantly less than the posterior one. There was significant
better back pain relief, kyphotic angle correction and
less angle loss in the posterior group than anterior. There
was no significant difference between the two groups
regarding neurological recovery, functional outcome and
fusion rate.
Conclusion Both anterolateral and posterolateral approaches
are sufficient for achieving the goals of surgical
treatment of thoracic and lumbar Pott’s disease but posterolateral
approach allows significant better kyphotic
angle correction, less angle loss, better improvement in
back pain but unfortunately more operative time and blood
loss.