Skip to main content
Top
Published in: Journal of Orthopaedic Surgery and Research 1/2014

Open Access 01-12-2014 | Research article

RETRACTED ARTICLE: Clinical efficacy of posterior versus anterior instrumentation for the treatment of spinal tuberculosis in adults: a meta-analysis

Authors: Pinglin Yang, Xijing He, Haopeng Li, Quanjin Zang, Baohui Yang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2014

Login to get access

Abstract

Background

The aim of our study was to evaluate the clinical efficacy of posterior vs. anterior instrumentation for the treatment of spinal tuberculosis in adults.

Methods

The electronic databases such as PubMed, MEDLINE, Springer, EMBASE, Google scholar, and Cochrane library were searched to select the potentially relevant reports that compared the efficacy of posterior instrumentation group (group A) with anterior instrumentation group (group B) in the treatment of spinal tuberculosis. Outcome assessments were correction of angle, loss of correction, fusion rate of the grafting bone, and complications after surgery.

Results

This meta-analysis included four trials published between 2006 and 2012, involving 291 adult patients (group A, 154; group B, 137) with spinal tuberculosis. The overall meta-analysis showed that there were no significant differences (P > 0.01) between group A and group B in correction of angle and loss of correction at final follow-up after operation The pooled WMD (weighted mean difference) of group A and group B was 2.85 (95% CI (confidence interval) = -1.25 ~ 6.94) and 1.14 (95% CI = -3.07 ~ 5.34), respectively. Besides, no significant differences (P > 0.01) were observed in fusion rate of the grafting bone and complications after operation between group A and group B, and the pooled ORs (odds ratio) were 0.65 (95% CI = -0.23 ~ 1.85) and (95% CI = -0.19 ~ 1.50), respectively.

Conclusions

Our results suggested that the posterior instrumentation appeared to have the same clinical outcome with the anterior instrumentation in the treatment of the adult patients with spinal tuberculosis.
Appendix
Available only for authorised users
Literature
1.
go back to reference Karaeminogullari O, Aydinli U, Ozerdemoglu R, Ozturk C: Tuberculosis of the lumbar spine: outcomes after combined treatment of two-drug therapy and surgery. Orthopedics. 2007, 30: 55-59.PubMed Karaeminogullari O, Aydinli U, Ozerdemoglu R, Ozturk C: Tuberculosis of the lumbar spine: outcomes after combined treatment of two-drug therapy and surgery. Orthopedics. 2007, 30: 55-59.PubMed
2.
go back to reference Palle L, Reddy MB, Reddy KJ: Role of magnetic resonance diffusion imaging and apparent diffusion coefficient values in the evaluation of spinal tuberculosis in Indian patients. Indian J Radiol Imaging. 2010, 20: 279-10.4103/0971-3026.73544.PubMedCentralCrossRefPubMed Palle L, Reddy MB, Reddy KJ: Role of magnetic resonance diffusion imaging and apparent diffusion coefficient values in the evaluation of spinal tuberculosis in Indian patients. Indian J Radiol Imaging. 2010, 20: 279-10.4103/0971-3026.73544.PubMedCentralCrossRefPubMed
3.
go back to reference Pu X, Zhou Q, He Q, Dai F, Xu J, Zhang Z, Branko K: A posterior versus anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis. Int Orthop. 2012, 36: 307-313. 10.1007/s00264-011-1329-0.PubMedCentralCrossRefPubMed Pu X, Zhou Q, He Q, Dai F, Xu J, Zhang Z, Branko K: A posterior versus anterior surgical approach in combination with debridement, interbody autografting and instrumentation for thoracic and lumbar tuberculosis. Int Orthop. 2012, 36: 307-313. 10.1007/s00264-011-1329-0.PubMedCentralCrossRefPubMed
4.
go back to reference Jin D, Qu D, Chen J, Zhang H: One-stage anterior interbody autografting and instrumentation in primary surgical management of thoracolumbar spinal tuberculosis. Eur Spine J. 2004, 13: 114-121. 10.1007/s00586-003-0661-5.PubMedCentralCrossRefPubMed Jin D, Qu D, Chen J, Zhang H: One-stage anterior interbody autografting and instrumentation in primary surgical management of thoracolumbar spinal tuberculosis. Eur Spine J. 2004, 13: 114-121. 10.1007/s00586-003-0661-5.PubMedCentralCrossRefPubMed
5.
go back to reference Ramachandran S, Clifton I, Collyns T, Watson J, Pearson S: The treatment of spinal tuberculosis: a retrospective study. Int J Tuberc Lung Dis. 2005, 9: 541-544.PubMed Ramachandran S, Clifton I, Collyns T, Watson J, Pearson S: The treatment of spinal tuberculosis: a retrospective study. Int J Tuberc Lung Dis. 2005, 9: 541-544.PubMed
6.
go back to reference Sahoo MM, Mahapatra SK, Sethi GC, Dash SK: Posterior-only approach surgery for fixation and decompression of thoracolumbar spinal tuberculosis: a retrospective study. J Spinal Disord Tech. 2012, 25: E217-E223. 10.1097/BSD.0b013e31826a088e.CrossRefPubMed Sahoo MM, Mahapatra SK, Sethi GC, Dash SK: Posterior-only approach surgery for fixation and decompression of thoracolumbar spinal tuberculosis: a retrospective study. J Spinal Disord Tech. 2012, 25: E217-E223. 10.1097/BSD.0b013e31826a088e.CrossRefPubMed
7.
go back to reference Talu U, Gogus A, Ozturk C, Hamzaoglu A, Domanic U: The role of posterior instrumentation and fusion after anterior radical debridement and fusion in the surgical treatment of spinal tuberculosis: experience of 127 cases. J Spinal Disord Tech. 2006, 19: 554-559. 10.1097/01.bsd.0000211202.93125.c7.CrossRefPubMed Talu U, Gogus A, Ozturk C, Hamzaoglu A, Domanic U: The role of posterior instrumentation and fusion after anterior radical debridement and fusion in the surgical treatment of spinal tuberculosis: experience of 127 cases. J Spinal Disord Tech. 2006, 19: 554-559. 10.1097/01.bsd.0000211202.93125.c7.CrossRefPubMed
8.
go back to reference Albee FH: The classic: transplantation of a portion of the tibia into the spine for Pott's disease: a preliminary report. Clin Orthop Relat Res. 2007, 460: 14-16.CrossRefPubMed Albee FH: The classic: transplantation of a portion of the tibia into the spine for Pott's disease: a preliminary report. Clin Orthop Relat Res. 2007, 460: 14-16.CrossRefPubMed
9.
go back to reference Hibbs RA: The classic: an operation for progressive spinal deformities: a preliminary report of three cases from the service of the orthopaedic hospital. Clin Orthop Relat Res. 2007, 460: 17-20.CrossRefPubMed Hibbs RA: The classic: an operation for progressive spinal deformities: a preliminary report of three cases from the service of the orthopaedic hospital. Clin Orthop Relat Res. 2007, 460: 17-20.CrossRefPubMed
10.
go back to reference Ma YZ, Cui X, Li HW, Chen X, Cai XJ, Bai YB: Outcomes of anterior and posterior instrumentation under different surgical procedures for treating thoracic and lumbar spinal tuberculosis in adults. Int Orthop. 2012, 36: 299-305. 10.1007/s00264-011-1390-8.PubMedCentralCrossRefPubMed Ma YZ, Cui X, Li HW, Chen X, Cai XJ, Bai YB: Outcomes of anterior and posterior instrumentation under different surgical procedures for treating thoracic and lumbar spinal tuberculosis in adults. Int Orthop. 2012, 36: 299-305. 10.1007/s00264-011-1390-8.PubMedCentralCrossRefPubMed
11.
go back to reference Garg B, Kandwal P, Nagaraja UB, Goswami A, Jayaswal A: Anterior versus posterior procedure for surgical treatment of thoracolumbar tuberculosis: a retrospective analysis. Indian J Orthop. 2012, 46: 165-10.4103/0019-5413.93682.PubMedCentralCrossRefPubMed Garg B, Kandwal P, Nagaraja UB, Goswami A, Jayaswal A: Anterior versus posterior procedure for surgical treatment of thoracolumbar tuberculosis: a retrospective analysis. Indian J Orthop. 2012, 46: 165-10.4103/0019-5413.93682.PubMedCentralCrossRefPubMed
12.
go back to reference Lee S-H, Sung J-K, Park Y-M: Single-stage transpedicular decompression and posterior instrumentation in treatment of thoracic and thoracolumbar spinal tuberculosis: a retrospective case series. J Spinal Disord Tech. 2006, 19: 595-602. 10.1097/01.bsd.0000211241.06588.7b.CrossRefPubMed Lee S-H, Sung J-K, Park Y-M: Single-stage transpedicular decompression and posterior instrumentation in treatment of thoracic and thoracolumbar spinal tuberculosis: a retrospective case series. J Spinal Disord Tech. 2006, 19: 595-602. 10.1097/01.bsd.0000211241.06588.7b.CrossRefPubMed
13.
go back to reference Munafo MR, Flint J: Meta-analysis of genetic association studies. Trends Genet. 2004, 20: 439-444. 10.1016/j.tig.2004.06.014.CrossRefPubMed Munafo MR, Flint J: Meta-analysis of genetic association studies. Trends Genet. 2004, 20: 439-444. 10.1016/j.tig.2004.06.014.CrossRefPubMed
14.
go back to reference Deeks JJ, Altman DG, Bradburn MJ: Statistical methods for examining heterogeneity and combining results from several studies in meta‒analysis. Systematic Reviews in Health Care: Meta-Analysis in Context. Edited by: Egger M, Smith GD, Altman DG. 2001, London: BMJ, 285-312. 2CrossRef Deeks JJ, Altman DG, Bradburn MJ: Statistical methods for examining heterogeneity and combining results from several studies in meta‒analysis. Systematic Reviews in Health Care: Meta-Analysis in Context. Edited by: Egger M, Smith GD, Altman DG. 2001, London: BMJ, 285-312. 2CrossRef
15.
go back to reference Higgins JP, Thompson SG, Deeks JJ, Altman DG: Measuring inconsistency in meta-analyses. Br Med J. 2003, 327: 557-10.1136/bmj.327.7414.557.CrossRef Higgins JP, Thompson SG, Deeks JJ, Altman DG: Measuring inconsistency in meta-analyses. Br Med J. 2003, 327: 557-10.1136/bmj.327.7414.557.CrossRef
16.
go back to reference Mantel N, Haenszel W: Statistical aspects of the analysis of data from retrospective studies of disease. The Challenge of Epidemiology: Issues and Selected Readings. 2004, 1: 533-553. Mantel N, Haenszel W: Statistical aspects of the analysis of data from retrospective studies of disease. The Challenge of Epidemiology: Issues and Selected Readings. 2004, 1: 533-553.
17.
go back to reference DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials. 1986, 7: 177-188. 10.1016/0197-2456(86)90046-2.CrossRefPubMed DerSimonian R, Laird N: Meta-analysis in clinical trials. Control Clin Trials. 1986, 7: 177-188. 10.1016/0197-2456(86)90046-2.CrossRefPubMed
18.
go back to reference Güzey FK, Emel E, Bas NS, Hacisalihoglu S, Seyithanoglu H, Karacor SE, Ozkan N, Alatas I, Sel B: Thoracic and lumbar tuberculous spondylitis treated by posterior debridement, graft placement, and instrumentation: a retrospective analysis in 19 cases. J Neurosurg Spine. 2005, 3: 450-458. 10.3171/spi.2005.3.6.0450.CrossRefPubMed Güzey FK, Emel E, Bas NS, Hacisalihoglu S, Seyithanoglu H, Karacor SE, Ozkan N, Alatas I, Sel B: Thoracic and lumbar tuberculous spondylitis treated by posterior debridement, graft placement, and instrumentation: a retrospective analysis in 19 cases. J Neurosurg Spine. 2005, 3: 450-458. 10.3171/spi.2005.3.6.0450.CrossRefPubMed
19.
go back to reference El-Sharkawi MM, Said GZ: Instrumented circumferential fusion for tuberculosis of the dorso-lumbar spine. A single or double stage procedure?. Int Orthop. 2012, 36: 315-324. 10.1007/s00264-011-1401-9.PubMedCentralCrossRefPubMed El-Sharkawi MM, Said GZ: Instrumented circumferential fusion for tuberculosis of the dorso-lumbar spine. A single or double stage procedure?. Int Orthop. 2012, 36: 315-324. 10.1007/s00264-011-1401-9.PubMedCentralCrossRefPubMed
20.
go back to reference Jain A, Dhammi I, Prashad B, Sinha S, Mishra P: Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach. J Bone Joint Surg Br. 2008, 90: 1477-1481.CrossRefPubMed Jain A, Dhammi I, Prashad B, Sinha S, Mishra P: Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach. J Bone Joint Surg Br. 2008, 90: 1477-1481.CrossRefPubMed
21.
go back to reference Mehta J, Bhojraj S: Tuberculosis of the thoracic spine a classification based on the selection of surgical strategies. J Bone Joint Surg Br. 2001, 83: 859-863. 10.1302/0301-620X.83B6.11142.CrossRefPubMed Mehta J, Bhojraj S: Tuberculosis of the thoracic spine a classification based on the selection of surgical strategies. J Bone Joint Surg Br. 2001, 83: 859-863. 10.1302/0301-620X.83B6.11142.CrossRefPubMed
22.
go back to reference Zhao J, Lian XF, Hou TS, Ma H, Chen ZM: Anterior debridement and bone grafting of spinal tuberculosis with one-stage instrumentation anteriorly or posteriorly. Int Orthop. 2007, 31: 859-863. 10.1007/s00264-006-0253-1.PubMedCentralCrossRefPubMed Zhao J, Lian XF, Hou TS, Ma H, Chen ZM: Anterior debridement and bone grafting of spinal tuberculosis with one-stage instrumentation anteriorly or posteriorly. Int Orthop. 2007, 31: 859-863. 10.1007/s00264-006-0253-1.PubMedCentralCrossRefPubMed
23.
go back to reference Moon M-S, Woo Y-K, Lee K-S, Ha K-Y, Kim S-S, Sun D-H: Posterior instrumentation and anterior interbody fusion for tuberculous kyphosis of dorsal and lumbar spines. Spine. 1995, 20: 1910-1916. 10.1097/00007632-199509000-00013.CrossRefPubMed Moon M-S, Woo Y-K, Lee K-S, Ha K-Y, Kim S-S, Sun D-H: Posterior instrumentation and anterior interbody fusion for tuberculous kyphosis of dorsal and lumbar spines. Spine. 1995, 20: 1910-1916. 10.1097/00007632-199509000-00013.CrossRefPubMed
24.
go back to reference Chen W-J, Wu C-C, Jung C-H, Chen L-H, Niu C-C, Lai P-L: Combined anterior and posterior surgeries in the treatment of spinal tuberculous spondylitis. Clin Orthop Relat Res. 2002, 398: 50-59.CrossRefPubMed Chen W-J, Wu C-C, Jung C-H, Chen L-H, Niu C-C, Lai P-L: Combined anterior and posterior surgeries in the treatment of spinal tuberculous spondylitis. Clin Orthop Relat Res. 2002, 398: 50-59.CrossRefPubMed
25.
go back to reference Sundararaj G, Behera S, Ravi V, Venkatesh K, Cherian V, Lee V: Role of posterior stabilisation in the management of tuberculosis of the dorsal and lumbar spine. J Bone Joint Surg Br. 2003, 85: 100-106. 10.1302/0301-620X.85B1.13300.CrossRefPubMed Sundararaj G, Behera S, Ravi V, Venkatesh K, Cherian V, Lee V: Role of posterior stabilisation in the management of tuberculosis of the dorsal and lumbar spine. J Bone Joint Surg Br. 2003, 85: 100-106. 10.1302/0301-620X.85B1.13300.CrossRefPubMed
26.
go back to reference Pang X, Shen X, Wu P, Luo C, Xu Z, Wang X: Thoracolumbar spinal tuberculosis with psoas abscesses treated by one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural drainage. Arch Orthop Trauma Surg. 2013, 133: 765-772. 10.1007/s00402-013-1722-9.CrossRefPubMed Pang X, Shen X, Wu P, Luo C, Xu Z, Wang X: Thoracolumbar spinal tuberculosis with psoas abscesses treated by one-stage posterior transforaminal lumbar debridement, interbody fusion, posterior instrumentation, and postural drainage. Arch Orthop Trauma Surg. 2013, 133: 765-772. 10.1007/s00402-013-1722-9.CrossRefPubMed
27.
go back to reference Moreno SG, Sutton AJ, Thompson JR, Ades A, Abrams KR, Cooper NJ: A generalized weighting regression‒derived meta‒analysis estimator robust to small‒study effects and heterogeneity. Stat Med. 2012, 31: 1407-1417. 10.1002/sim.4488.CrossRefPubMed Moreno SG, Sutton AJ, Thompson JR, Ades A, Abrams KR, Cooper NJ: A generalized weighting regression‒derived meta‒analysis estimator robust to small‒study effects and heterogeneity. Stat Med. 2012, 31: 1407-1417. 10.1002/sim.4488.CrossRefPubMed
Metadata
Title
RETRACTED ARTICLE: Clinical efficacy of posterior versus anterior instrumentation for the treatment of spinal tuberculosis in adults: a meta-analysis
Authors
Pinglin Yang
Xijing He
Haopeng Li
Quanjin Zang
Baohui Yang
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2014
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/1749-799X-9-10

Other articles of this Issue 1/2014

Journal of Orthopaedic Surgery and Research 1/2014 Go to the issue