{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:15:25Z","timestamp":1792095325078,"version":"4.4.0"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81802167"],"award-info":[{"award-number":["81802167"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Natural Science Research Plan in Shaanxi Province of China","award":["2019JM197"],"award-info":[{"award-number":["2019JM197"]}]},{"name":"Medical Research Project of Xi'an Science and Technology Bureau","award":["201805096YX4SF30-4"],"award-info":[{"award-number":["201805096YX4SF30-4"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In recent years, with the in-depth research on spinal tuberculosis, posterior surgery alone has been praised highly by more and more surgeons due to the better correction of kyphosis, better maintenance of spinal physiological curvature, smaller surgical trauma and fewer surgical complications. However, there is currently lack of relevant reports about the efficacy of posterior surgery alone in the treatment of tuberculosis in the T4\u20136 segments. This study aimed to evaluate the clinical study efficacy and feasibility of one-stage posterior-only surgical treatment for thoracic spinal tuberculosis in the T4\u20136 segments. 67 patients with tuberculosis in T4\u20136 segments who underwent one-stage posterior-only surgery were included in this study. The clinical efficacy was evaluated using statistical analysis based on the data about erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Oswestry Dability Index (ODI) score, Visual Analogue Scale (VAS) score and Cobb angle before surgery, after surgery and at the last follow-up. All patients completed fusion during the follow-up period of 6\u20139\u00a0months. ESR and CRP were returned to normal for all patients at 6\u00a0months follow-up. In the meanwhile, among the 27 patients combined with neurological impairment, neurological functions of 22 cases (81.48%) recovered completely at the last follow-up (P\u2009&lt;\u20090.05). Cobb angle of the kyphosis was improved from preoperative 34.8\u2009\u00b1\u200910.9\u00b0 to postoperative 9.6\u2009\u00b1\u20092.8\u00b0, maintaining at 11.3\u2009\u00b1\u20093.2\u00b0 at the last follow-up, The ODI and VAS scores were improved by 77.10% and 81.70%, respectively. This 5-year follow-up study shows that better clinical efficacy can be achieved for tuberculosis in T4\u20136 segments using one-stage posterior-only approach by costotransverse debridement in combination with bone graft and internal fixation. The posterior surgical method cannot only effectively accomplish debridement, obtain satisfactory clinical results, but also well correct kyphotic deformity and maintain it.<\/jats:p>","DOI":"10.1038\/s41598-021-04138-2","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T06:03:21Z","timestamp":1641535401000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Efficacy analysis of one-stage posterior-only surgical treatment for thoracic spinal tuberculosis in the T4\u20136 segments with minimum 5-year follow-up"],"prefix":"10.1038","volume":"12","author":[{"given":"Yi","family":"Zhan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Kang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinliang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingbo","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dingjun","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"4138_CR1","unstructured":"World health organization. Global tuberculosis report 2019. WHO 2019; https:\/\/www.who.int\/tb\/publications\/global_report\/en\/. (2020)."},{"key":"4138_CR2","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1186\/s13018-017-0650-8","volume":"12","author":"Y Huang","year":"2017","unstructured":"Huang, Y. et al. A posterior versus anterior debridement in combination with bone graft and internal fixation for lumbar and thoracic tuberculosis. J. Orthop. Surg. Res. 12, 150. https:\/\/doi.org\/10.1186\/s13018-017-0650-8 (2017).","journal-title":"J. Orthop. Surg. Res."},{"key":"4138_CR3","first-page":"58","volume":"16","author":"EM Trecarichi","year":"2012","unstructured":"Trecarichi, E. M., Di Meco, E., Mazzotta, V. & Fantoni, M. Tuberculous spondylodiscitis: Epidemiology, clinical features, treatment, and outcome. Eur. Rev. Med. Pharmacol. Sci. 16, 58\u201372 (2012).","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"4138_CR4","doi-asserted-by":"publisher","first-page":"1208","DOI":"10.1302\/0301-620X.100B9.BJJ-2017-1326.R2","volume":"100","author":"U Ukunda","year":"2018","unstructured":"Ukunda, U. & Lukhele, M. M. The posterior-only surgical approach in the treatment of tuberculosis of the spine: outcomes using cortical bone allografts. Bone Jt. J. 100, 1208\u20131213. https:\/\/doi.org\/10.1302\/0301-620X.100B9.BJJ-2017-1326.R2 (2018).","journal-title":"Bone Jt. J."},{"key":"4138_CR5","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1179\/2045772311Y.0000000023","volume":"34","author":"RK Garg","year":"2011","unstructured":"Garg, R. K. & Somvanshi, D. S. Spinal tuberculosis: A review. J. Spinal Cord Med. 34, 440\u2013454. https:\/\/doi.org\/10.1179\/2045772311Y.0000000023 (2011).","journal-title":"J. Spinal Cord Med."},{"key":"4138_CR6","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.jos.2018.08.012","volume":"24","author":"Z Li","year":"2019","unstructured":"Li, Z. et al. Surgical management for middle or lower thoracic spinal tuberculosis (T5\u2013T12) in elderly patients: Posterior versus anterior approach. J. Orthop. Sci. 24, 68\u201374. https:\/\/doi.org\/10.1016\/j.jos.2018.08.012 (2019).","journal-title":"J. Orthop. Sci."},{"issue":"4","key":"4138_CR7","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1007\/s00586-012-2335-7","volume":"22","author":"AK Jain","year":"2013","unstructured":"Jain, A. K. & Kumar, J. Tuberculosis of spine: neurological deficit. Eur. Spine J. 22(4), 624\u2013633. https:\/\/doi.org\/10.1007\/s00586-012-2335-7 (2013).","journal-title":"Eur. Spine J."},{"key":"4138_CR8","doi-asserted-by":"publisher","first-page":"1762","DOI":"10.1016\/j.athoracsur.2008.07.087","volume":"86","author":"BL Pettiford","year":"2008","unstructured":"Pettiford, B. L. et al. Technical challenges and utility of anterior exposure for thoracic spine pathology. Ann. Thorac. Surg. 86, 1762\u20131768. https:\/\/doi.org\/10.1016\/j.athoracsur.2008.07.087 (2008).","journal-title":"Ann. Thorac. Surg."},{"key":"4138_CR9","doi-asserted-by":"publisher","first-page":"337","DOI":"10.3171\/spi.2002.97.3.0337","volume":"97","author":"HJ Seol","year":"2002","unstructured":"Seol, H. J., Chung, C. K. & Kim, H. J. Surgical approach to anterior compression in the upper thoracic spine. J. Neurosurg. 97, 337\u2013342. https:\/\/doi.org\/10.3171\/spi.2002.97.3.0337 (2002).","journal-title":"J. Neurosurg."},{"key":"4138_CR10","doi-asserted-by":"publisher","first-page":"226","DOI":"10.3171\/spi.2005.2.2.0226","volume":"2","author":"M Tamura","year":"2005","unstructured":"Tamura, M., Saito, M., Machida, M. & Shibasaki, K. A transsternoclavicular approach for the anterior decompression and fusion of the upper thoracic spine. Technical note. J. Neurosurg. Spine 2, 226\u2013229. https:\/\/doi.org\/10.3171\/spi.2005.2.2.0226 (2005).","journal-title":"J. Neurosurg. Spine"},{"key":"4138_CR11","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1097\/01.bsd.0000211281.68400.1b","volume":"20","author":"HQ Zhang","year":"2007","unstructured":"Zhang, H. Q. et al. One-stage surgical management for multilevel tuberculous spondylitis of the upper thoracic region by anterior decompression, strut autografting, posterior instrumentation, and fusion. J. Spinal Disord. Tech. 20, 263\u2013267. https:\/\/doi.org\/10.1097\/01.bsd.0000211281.68400.1b (2007).","journal-title":"J. Spinal Disord. Tech."},{"key":"4138_CR12","doi-asserted-by":"publisher","first-page":"e842","DOI":"10.1016\/j.wneu.2017.11.126","volume":"110","author":"W Wu","year":"2018","unstructured":"Wu, W. et al. Surgical treatment of thoracic spinal tuberculosis: A multicenter retrospective study. World Neurosurg. 110, e842\u2013e850. https:\/\/doi.org\/10.1016\/j.wneu.2017.11.126 (2018).","journal-title":"World Neurosurg."},{"key":"4138_CR13","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1007\/s00586-003-0661-5","volume":"13","author":"D Jin","year":"2004","unstructured":"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. 13, 114\u2013121. https:\/\/doi.org\/10.1007\/s00586-003-0661-5 (2004).","journal-title":"Eur. Spine J."},{"key":"4138_CR14","doi-asserted-by":"publisher","first-page":"461","DOI":"10.3171\/2010.4.SPINE09808","volume":"13","author":"X Zengming","year":"2010","unstructured":"Zengming, X., Maolin, H., Xinli, Z. & Qianfen, C. Anterior transsternal approach for a lesion in the upper thoracic vertebral body. J. Neurosurg. Spine 13, 461\u2013468. https:\/\/doi.org\/10.3171\/2010.4.SPINE09808 (2010).","journal-title":"J. Neurosurg. Spine"},{"key":"4138_CR15","doi-asserted-by":"publisher","first-page":"409","DOI":"10.4103\/0019-5413.69315","volume":"44","author":"AK Jain","year":"2010","unstructured":"Jain, A. K., Dhammi, I. K., Jain, S. & Kumar, J. Simultaneously anterior decompression and posterior instrumentation by extrapleural retroperitoneal approach in thoracolumbar lesions. Indian J. Orthop. 44, 409\u2013416. https:\/\/doi.org\/10.4103\/0019-5413.69315 (2010).","journal-title":"Indian J. Orthop."},{"key":"4138_CR16","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1097\/BRS.0000000000001955","volume":"42","author":"LJ Wang","year":"2017","unstructured":"Wang, L. J. et al. Comparison of three surgical approaches for thoracic spinal tuberculosis in adult: Minimum 5-year follow up. Spine 42, 808\u2013817. https:\/\/doi.org\/10.1097\/BRS.0000000000001955 (2017).","journal-title":"Spine"},{"key":"4138_CR17","doi-asserted-by":"publisher","first-page":"1056","DOI":"10.1007\/s00586-016-4451-2","volume":"25","author":"K Hassan","year":"2016","unstructured":"Hassan, K. & Elmorshidy, E. Anterior versus posterior approach in surgical treatment of tuberculous spondylodiscitis of thoracic and lumbar spine. Eur. Spine J. 25, 1056\u20131063. https:\/\/doi.org\/10.1007\/s00586-016-4451-2 (2016).","journal-title":"Eur. Spine J."},{"key":"4138_CR18","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s13018-019-1063-7","volume":"14","author":"C Zhao","year":"2019","unstructured":"Zhao, C. et al. Can a posterior approach effectively heal thoracic and lumbar tuberculosis? Microbiology outcomes of the operative area. J. Orthop. Surg. Res. 14, 24. https:\/\/doi.org\/10.1186\/s13018-019-1063-7 (2019).","journal-title":"J. Orthop. Surg. Res."},{"key":"4138_CR19","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1302\/0301-620X.98B6.36472","volume":"98","author":"ST Wang","year":"2016","unstructured":"Wang, S. T. et al. Anterior debridement may not be necessary in the treatment of tuberculous spondylitis of the thoracic and lumbar spine in adults: a retrospective study. Bone Jt. J. 98, 834\u2013839. https:\/\/doi.org\/10.1302\/0301-620X.98B6.36472 (2016).","journal-title":"Bone Jt. J."},{"key":"4138_CR20","doi-asserted-by":"publisher","first-page":"616","DOI":"10.1007\/s00586-012-2470-1","volume":"22","author":"H Zhang","year":"2013","unstructured":"Zhang, H. et al. One-stage surgical treatment for upper thoracic spinal tuberculosis by internal fixation, debridement, and combined interbody and posterior fusion via posterior-only approach. Eur. Spine J. 22, 616\u2013623. https:\/\/doi.org\/10.1007\/s00586-012-2470-1 (2013).","journal-title":"Eur. Spine J."},{"key":"4138_CR21","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1007\/s00586-012-2335-7","volume":"22","author":"AK Jain","year":"2013","unstructured":"Jain, A. K. & Kumar, J. Tuberculosis of spine: Neurological deficit. Eur. Spine J. 22, 624\u2013633. https:\/\/doi.org\/10.1007\/s00586-012-2335-7 (2013).","journal-title":"Eur. Spine J."},{"key":"4138_CR22","doi-asserted-by":"publisher","first-page":"6933","DOI":"10.1038\/s41598-018-25142-z","volume":"8","author":"B Wang","year":"2018","unstructured":"Wang, B. et al. Recurrent complex spinal tuberculosis accompanied by sinus tract formation: Causes of recurrence and clinical treatments. Sci. Rep. 8, 6933. https:\/\/doi.org\/10.1038\/s41598-018-25142-z (2018).","journal-title":"Sci. Rep."},{"key":"4138_CR23","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1186\/s12891-019-2539-7","volume":"20","author":"B Wang","year":"2019","unstructured":"Wang, B. et al. Evaluation of clinical outcomes of one-stage anterior and posterior surgical treatment for atlantoaxial tuberculosis complicated with neurological damage. BMC Musculoskelet. Disord. 20, 148. https:\/\/doi.org\/10.1186\/s12891-019-2539-7 (2019).","journal-title":"BMC Musculoskelet. Disord."},{"key":"4138_CR24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0192581","volume":"13","author":"Z Zhu","year":"2018","unstructured":"Zhu, Z. et al. Selection of surgical treatment approaches for cervicothoracic spinal tuberculosis: A 10-year case review. PLoS ONE 13, e0192581. https:\/\/doi.org\/10.1371\/journal.pone.0192581 (2018).","journal-title":"PLoS ONE"},{"key":"4138_CR25","doi-asserted-by":"publisher","first-page":"294","DOI":"10.4184\/asj.2017.11.2.294","volume":"11","author":"SK Srivastava","year":"2017","unstructured":"Srivastava, S. K., Aggarwal, R. A., Bhosale, S. K., Roy, K. & Nemade, P. S. The versatile approach: A novel single incision combined with anterior and posterior approaches for decompression and instrumented fusion to treat tuberculosis of the thoracic spine. Asian Spine J. 11, 294\u2013304. https:\/\/doi.org\/10.4184\/asj.2017.11.2.294 (2017).","journal-title":"Asian Spine J."},{"key":"4138_CR26","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.clineuro.2014.10.019","volume":"128","author":"P Liu","year":"2015","unstructured":"Liu, P., Sun, M., Li, S., Wang, Z. & Ding, G. A retrospective controlled study of three different operative approaches for the treatment of thoracic and lumbar spinal tuberculosis: three years of follow-up. Clin. Neurol. Neurosurg. 128, 25\u201334. https:\/\/doi.org\/10.1016\/j.clineuro.2014.10.019 (2015).","journal-title":"Clin. Neurol. Neurosurg."},{"key":"4138_CR27","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1111\/os.12140","volume":"6","author":"JD Shi","year":"2014","unstructured":"Shi, J. D., Wang, Q. & Wang, Z. L. Primary issues in the selection of surgical procedures for thoracic and lumbar spinal tuberculosis. Orthop. Surg. 6, 259\u2013268. https:\/\/doi.org\/10.1111\/os.12140 (2014).","journal-title":"Orthop. Surg."},{"key":"4138_CR28","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1111\/j.1757-7861.2010.00104.x","volume":"2","author":"H Jiang","year":"2010","unstructured":"Jiang, H., Xiao, Z. M., Zhan, X. L. & He, M. L. Anterior transsternal approach for treatment of upper thoracic vertebral tuberculosis. Orthop. Surg. 2, 305\u2013309. https:\/\/doi.org\/10.1111\/j.1757-7861.2010.00104.x (2010).","journal-title":"Orthop. Surg."},{"key":"4138_CR29","doi-asserted-by":"publisher","first-page":"1900","DOI":"10.1097\/MD.0000000000001900","volume":"94","author":"B Lin","year":"2015","unstructured":"Lin, B. et al. Subscapularis transthoracic versus posterolateral approaches in the surgical management of upper thoracic tuberculosis: A prospective. Random. Controll. Study. Med. 94, 1900. https:\/\/doi.org\/10.1097\/MD.0000000000001900 (2015).","journal-title":"Random. Controll. Study. Med."},{"key":"4138_CR30","doi-asserted-by":"publisher","unstructured":"Wang, K., Wang, N., Wang, Y., Xia, Y., Song, F., & Liu, J. Anterior versus posterior instrumentation for treatment of thoracolumbar tuberculosis : A meta-analysis. Anteriore vs. posteriore Instrumentierung zur Therapie der thorakolumbalen Tuberkulose : Eine Metaanalyse. Der Orthopade. 48, 207\u2013212. https:\/\/doi.org\/10.1007\/s00132-018-03662-w (2019).","DOI":"10.1007\/s00132-018-03662-w"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-04138-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-04138-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-04138-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T14:58:21Z","timestamp":1669301901000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-04138-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,7]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["4138"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-04138-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-769455\/v1","asserted-by":"object"}]},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,7]]},"assertion":[{"value":"31 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"149"}}