{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T05:34:02Z","timestamp":1793252042126,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T00:00:00Z","timestamp":1674086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Posterior approach of debridement, interbody graft, and instrumentation, and combined posterior\u2013anterior approach of posterior instrumentation and anterior debridement and interbody graft are two essential surgeries for the surgical treatment of spinal tuberculosis (TB), and, until now, which one should be chosen is still controversial. This study aimed to compare the therapeutic efficacy between the single posterior surgery and combined posterior\u2013anterior surgery for lumbar tuberculosis (LTB) patients to elucidate the role of debridement and the effects that result from posterior structure resection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>One hundred and nineteen LTB patients managed with single posterior debridement, interbody graft, and instrumentation surgery (Group P, 73 cases), or combined posterior\u2013anterior surgery of posterior instrumentation and anterior debridement and interbody graft (Group P\u2010A, 46 cases) from January 2008 to December 2016 were retrospectively analyzed. Different indexes were compared between the two groups to evaluate the curative effect and explore the role of debridement and the effects that result from posterior structure resection: operation time, blood loss, visual analog scale (VAS), Japanese Orthopaedic Association (JOA), Erythrocyte Sedimentation Rate (ESR), C\u2010reactive Protein (CRP), surgical complication type and rate, spinopelvic sagittal parameters (local kyphosis [LK], pelvic incidence [PI] and pelvic tilt [PT], lumbar lordosis [LL], and sacral slope [SS]), drainage retention duration, hospital stay, time of abscess disappearance, time of activity recovery, and time of bone graft fusion by <jats:italic>t<\/jats:italic>\u2010test or \u03c7<jats:sup>2<\/jats:sup> test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The follow\u2010up period ranged from 24 to 60\u00a0months. No significant variations were detected between the two groups for age, sex ratio, BMI, disease duration, indication, and the preoperative values of VAS, JOA, ESR, CRP, and LK (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). The VAS, JOA, ESR, and CRP significantly improved in both groups after the operation (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05), along with the LK and LL (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Meanwhile, the SS, PI, and PT showed minor improvement after the operation (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Compared to the P\u2010A group, the P group had shorter operation time and less blood loss and hospital stay (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). However, both groups presented similar VAS, JOA, ESR, CRP, and LK improvements (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). Additionally, the surgical complication type and rate, postoperative spinopelvic sagittal parameters, and bone graft fusion time did not differ between the two groups (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05). On the other hand, the patients in the P\u2010A group had a shorter time of abscess disappearance and activity recovery (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) but a similar time of drainage retention (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05) compared to the P group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Both single posterior and combined posterior\u2013anterior surgeries presented a good therapeutic effect for LTB patients with a low surgical complication rate and good quality of LK correction and LL reconstruction and maintenance. Moreover, single posterior surgery was less traumatic than combined posterior\u2013anterior surgery but with slower TB lesion healing and activity recovery. Compared to debridement, stability seems to be more vital for STB healing, posterior structure resection does not affect the effect of spinopelvic realignment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13628","type":"journal-article","created":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T08:27:52Z","timestamp":1674116872000},"page":"868-877","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Single Posterior Surgery Versus Combined Posterior\u2013Anterior Surgery for Lumbar Tuberculosis Patients"],"prefix":"10.1111","volume":"15","author":[{"given":"Dapeng","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Orthopedic Shaanxi Provincial People's Hospital  Xi'an China"},{"name":"Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaqing","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Shaanxi Provincial People's Hospital  Xi'an China"},{"name":"Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liqun","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Shaanxi Provincial People's Hospital  Xi'an China"},{"name":"Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yayi","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Shaanxi Provincial People's Hospital  Xi'an China"},{"name":"Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Shaanxi Provincial People's Hospital  Xi'an China"},{"name":"Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongchun","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Shaanxi Provincial People's Hospital  Xi'an China"},{"name":"Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7432-3310","authenticated-orcid":false,"given":"Weiwei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Shaanxi Provincial People's Hospital  Xi'an China"},{"name":"Xi'an Medical University  Xi'an China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.100B4"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001956.pub3"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04335-0"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-021-04078-y"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-021-05296-8"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-011-1449-6"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-011-1389-1"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/10790268.2019.1607454"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-016-3234-z"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2015.01.041"},{"issue":"7","key":"e_1_2_7_12_1","first-page":"411","article-title":"One\u2010stage posterior surgery for treatment of advanced spinal tuberculosis","volume":"66","author":"Chen YC","year":"2003","journal-title":"J Chin Med Assoc"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12955"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.18004418508"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-012-1575-7"},{"key":"e_1_2_7_16_1","doi-asserted-by":"crossref","unstructured":"ZhengLiu PenghuiZhang WeiweiLi et al.Posterior\u2010only vs. combined posterior\u2010anterior approaches in treating lumbar and lumbosacral spinal tuberculosis: a retrospective study with minimum 7\u2010year follow\u2010J Orthop Surg Res.2020;15(1):99. 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