Meta Analysis Of Different Surgical Approach In Combination With Debridement, Interbody Autografting And Instrumentation For Adult Thoracic And Lumbar Tuberculosis

Objective: To assess the effectiveness of the anterior versus posterior debridement,interbody autografting and instrumentation for adult thoracic and lumbar tuberculosis.Method：In accordance with the strategy of the Cochrane network provided to search,including computer, manual and other retrieval. A computer-based online search ofPUBMED （1999to January，2012）, MEDLINE (1999to January2012), EMBASE(1999-2012), Chinese Biomedical Literature Database (CBM in1999to2012January),the China Academic Journal (CNKI1999to January2012) and Wanfang Database (1999to January2012)，and several hand searched related journals were performed，such as《Spine》、《Euro Spine》、《The Journal of Bone and Joint Surgery》、《Injury》、《Orthopedic Clinics of North America》. The included trials were screened out strictlybased on the criterion of inclusion and exclusion. The quality of included trials wasevaluated. Data were extracted by two reviewers independently. Use RevMan5.0.1software for data analysis. Result: Five studies involving357patients were included.There were166cases with anterior, and137cases with posterior. The results of Meta-analysis indicated that statistically significant difference were observed between twoapproaches with the surgical correction of kyphosis degrees（P＜0.01）.No differencewith regard to the duration of the operation, the operative blood loss, the number of thefusion segments, the last follow-up of loss of correction, ASIA score, Frankel score, thegraft fusion rate and complication were noted. Conclusion：Both anterior and posteriorapproach in combination with debridement, interbody autografting and instrumentation are effective treatment for adult thoracic and lumbar tuberculosis. However, comparedwith anterior approach,Posterior is better due to the correction of kyphosis degrees, Butthe choice of the specific way should also be overall considered.