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European Spine Journal

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01-12-2016 | Review Article

Comparison of clinical efficacy and safety among three surgical approaches for the treatment of spinal tuberculosis: a meta-analysis

Authors: Pinglin Yang, Quanjin Zang, Jian Kang, Haopeng Li, Xijing He

Published in: European Spine Journal | Issue 12/2016

Abstract

Purpose

We aimed to provide evidence for clinical choice of surgical approach in treating spinal tuberculosis, including anterior, posterior and combined approaches (combined anterior and posterior approach).

Methods

A literature search up to June 2015 was performed on PubMed, Embase, Cochrane library, CNKI, Wanfang and Weipu database. Weighted mean differences (WMDs) or risk radios (RRs) and their 95 % confidence intervals (CI) were calculated.

Results

Total 26 studies with 2345 spinal tuberculosis adults were analyzed. Results showed advantages of posterior approach compared with anterior approach in operation time (WMD = 20.91; 95 % CI: 9.05–32.76), blood loss (WMD = 72.32, 95 % CI: 13.87–130.78), correction of angle (WMD = −2.47; 95 % CI: −4.04 to −0.90) and complications (RR = 1.78; 95 % CI: 1.21–2.60), and compared with combined approach in operation time (WMD = −82.76; 95 % CI: −94.38 to −71.14), blood loss (WMD = −263.63; 95 % CI: −336.85 to −190.41), hospital stay [(WMD = −4.60; 95 % CI: −5.10 to −4.10) and complications (RR = 0.36; 95 % CI: 0.23–0.58]. Meanwhile, significantly larger correction of angle (WMD = −2.25; 95 % CI: −4.35 to −0.14; P = 0.04) and less loss of correction (WMD = 3.97; 95 % CI: 2.22–5.72) were found when compared combined approach with anterior approach. However, combined approach had significantly longer operation time (WMD = −41.92; 95 % CI: −52.45 to −31.38) and more blood loss (WMD = −102.18; 95 % CI: −160.45 to −43.91) than anterior approach.

Conclusion

Posterior approach has better clinical outcomes than anterior or combined approach for spinal tuberculosis. However, individual assessment of each case should be considered in the clinical application of these surgical approaches.

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Title: Comparison of clinical efficacy and safety among three surgical approaches for the treatment of spinal tuberculosis: a meta-analysis
Authors: Pinglin Yang
Quanjin Zang
Jian Kang
Haopeng Li
Xijing He
Publication date: 01-12-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 12/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4546-9

At a glance: The STEP trials

Springer Medicine

Comparison of clinical efficacy and safety among three surgical approaches for the treatment of spinal tuberculosis: a meta-analysis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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