{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T18:45:55Z","timestamp":1773773155875,"version":"3.50.1"},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,12,29]],"date-time":"2016-12-29T00:00:00Z","timestamp":1482969600000},"content-version":"vor","delay-in-days":58,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Capital Characteristic Clinic Project","award":["Z141107002514055"],"award-info":[{"award-number":["Z141107002514055"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the clinical outcomes of anterior and posterior instrumentation with different debridement and graft fusion methods for multi\u2010level contiguous thoracic spinal tuberculosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively evaluated 81 patients with multi\u2010level contiguous thoracic spinal tuberculosis who underwent anterior or posterior instrumentation combined with different methods of debridement, decompression, and graft fusion from <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>anuary 2002 to <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2012. All patients were divided into an anterior instrumentation group and a posterior instrumentation group. In the anterior instrumentation group, there were 39 patients who underwent transthoracic debridement. In the posterior instrumentation group, there were 34 patients who underwent trans\u2010costotransverse decompression and strut grafting with posterior instrumentation, and another 8 patients underwent combined anterior debridement and strut grafting with posterior instrumentation in a single\u2010stage or two\u2010stage procedure. The kyphotic angles were calculated from lateral spinal <jats:styled-content style=\"fixed-case\">X<\/jats:styled-content>\u2010rays using the modified <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>onstam method. The symptoms and signs of tuberculosis, fusion level, fusion time of the bone graft, average kyphosis angle, average correction, average loss of correction, and clinical complications were recorded. The average follow\u2010up period was 37\u2009months (range, 17\u201372\u2009months).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort consisted of 47 males and 34 females with an average age of 38\u2009years. The mean durations of the operations were 3.5 \u00b1 0.4\u2009h in the anterior group and 4.0 \u00b1 0.3\u2009h in the posterior group (<jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content> &lt; 0.05). The mean blood loss volumes during surgery were 450 \u00b1 42 and 560 \u00b1 51\u2009m<jats:styled-content style=\"fixed-case\">L<\/jats:styled-content> for the anterior group and the posterior group, respectively (<jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content> &lt; 0.01). The kyphotic deformities were corrected from 32.1\u00b0 \u00b1 10.3\u00b0 to 10.2\u00b0 \u00b1 2.1\u00b0 in the anterior group and from 33.8\u00b0 \u00b1 11.7\u00b0 to 12.6\u00b0 \u00b1 2.7\u00b0 in the posterior group (<jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content> &lt; 0.01). The neurologic statuses of the 23 patients with preoperative neurologic deficits improved in each group. Fusion was confirmed radiographically at 5.4 \u00b1 1.2\u2009months (range, 4\u201312\u2009months) in the anterior group and 5.6 \u00b1 1.4\u2009months (range, 4\u201313\u2009months) in the posterior group (<jats:styled-content style=\"fixed-case\">\n<jats:italic>P<\/jats:italic>\n<\/jats:styled-content> &gt; 0.05). Postoperative relapses were noted in 1 and 3 patients in the anterior and the posterior group, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Posterior instrumentation was more effective than anterior instrumentation in the correction of kyphosis and the maintenance of the correction. However, postoperative sinus formation was more frequent in patients who underwent a single\u2010stage posterior procedure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12288","type":"journal-article","created":{"date-parts":[[2016,12,29]],"date-time":"2016-12-29T12:40:27Z","timestamp":1483015227000},"page":"454-461","source":"Crossref","is-referenced-by-count":25,"title":["Anterior and Posterior Instrumentation with Different Debridement and Grafting Procedures for Multi\u2010Level Contiguous Thoracic Spinal Tuberculosis"],"prefix":"10.1111","volume":"8","author":[{"given":"Xu","family":"Cui","sequence":"first","affiliation":[{"name":"Department of Orthopaedics The 309th Hospital of the PLA  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li\u2010tao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics The 309th Hospital of the PLA  Beijing 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