Surgical Outcomes of Adults with Spinal Tuberculosis from 1992 to 2019: A Single-Center Study

Abstract

Abstract Objectives: This study aims to investigate the postoperative fusion rate and risk factors for kyphosis progression in adults affected with spinal tuberculosis. Methods: Overall, 134 patients with spinal tuberculosis from the thoracic to lumbar spine from 1992 to 2021 were included in this study. The patients were divided into Group A, comprising those who underwent only anterior spinal fusion (ASF); Group B, comprising those who underwent ASF and revision surgery; and Group C, comprising those who underwent planned ASF plus posterior instrumentation. Data concerning the affected level, bone fusion rate, and progression of the postoperative local kyphosis angle were collected. The risk factors for the progression of local kyphosis angle after ASF were determined using linear regression analysis. Results: The overall bone fusion rate was 83.2%. No significant differences in the bone fusion rate were detected between the three groups. Postoperative kyphosis did not progress in the thoracic and lumbar spine in the combined Group A+B; however, the kyphosis angle in the combined Group A+B progressed when the affected level occurred in the thoracolumbar region compared with the kyphosis progressive angle in Group C. Conclusion: In spinal tuberculosis, the fusion rate of ASF with only grafted bone was good; however, in patients affected in the thoracolumbar spine region, posterior instrumentation is desirable because of local kyphosis progression risk after surgery.