Purpose The aim of this study is to compare the clinical, radiological and functional outcome of anterior versus posterior surgical debridement and fixation in patients with thoracic and lumbar tuberculous spondylodiscitis. Patients and methods A total number of 42 patients with tuberculous spondylodiscitis of the thoracic and lumbar spine treated surgicallywere included in this study.Twenty patients (group A) underwent anterior debridement, decompression and instrumentation by anterior approach. Twenty-two patients (group B) were operated by posterolateral (extracavitary) decompression and posterior instrumentation. Operative parameters, clinical, radiographic and functional results for the two groups were analyzed and compared. Results The average follow-up period was 15 months (range 12–24) in both groups. The average operative time, blood loss and blood transfusion of anterior group were significantly less than the posterior one. There was significant better back pain relief, kyphotic angle correction and less angle loss in the posterior group than anterior. There was no significant difference between the two groups regarding neurological recovery, functional outcome and fusion rate. Conclusion Both anterolateral and posterolateral approaches are sufficient for achieving the goals of surgical treatment of thoracic and lumbar Pott’s disease but posterolateral approach allows significant better kyphotic angle correction, less angle loss, better improvement in back pain but unfortunately more operative time and blood loss.

Purpose The aim of this study is to compare the clinical, radiological and functional outcome of anterior versus posterior surgical debridement and fixation in patients with thoracic and lumbar tuberculous spondylodiscitis. Patients and methods A total number of 42 patients with tuberculous spondylodiscitis of the thoracic and lumbar spine treated surgicallywere included in this study.Twenty patients (group A) underwent anterior debridement, decompression and instrumentation by anterior approach. Twenty-two patients (group B) were operated by posterolateral (extracavitary) decompression and posterior instrumentation. Operative parameters, clinical, radiographic and functional results for the two groups were analyzed and compared. Results The average follow-up period was 15 months (range 12–24) in both groups. The average operative time, blood loss and blood transfusion of anterior group were significantly less than the posterior one. There was significant better back pain relief, kyphotic angle correction and less angle loss in the posterior group than anterior. There was no significant difference between the two groups regarding neurological recovery, functional outcome and fusion rate. Conclusion Both anterolateral and posterolateral approaches are sufficient for achieving the goals of surgical treatment of thoracic and lumbar Pott’s disease but posterolateral approach allows significant better kyphotic angle correction, less angle loss, better improvement in back pain but unfortunately more operative time and blood loss.

Background: Using anterior or posterior surgery for multilevel cervical spondylotic myelopathy continues to be the subject of considerable debate. Studies on the comparison of the 2 approaches are limited and few studies focus on anterior cervical discectomy and fusion (ACDF) versus open door laminoplasty(ODL). Study design: A prospective study. Objective: To compare the clinical outcomes, radiographic changes, and complications of patients with multilevel cervical spondylotic myelopathy who underwent ACDF and ODL in lordotic cervical spine. METHODS: We evaluated 40 patients (20 patients inthe ACDF group and 20 patients in the ODL group) at our institution from September 2005 to December 2008. They were followed up for minimum 2 years.The clinical outcomes(Nurick grade and JOA score), radiographic changes(x ray and MRI), and complications were compared between the 2 groups. RESULTS: ODL showed significant more operative time(155 min Vs 95 min)and more blood loss(438 ml Vs 215 ml)than ACDF.Both ACDF and ODL groups showed significant improvement in Nurick grade from 3.5 and 3.4 preoperatively to 1.85 and 1.95 respectively at last follow up(P0.05). Both groups significantly improved the JOA (P0.05)and recovery rate(RR) was similar(63.2% in ACDF group and 64.4% in ODL group) (P0.05).The cervical motion (on dynamic lateral x-ray)significantly decreasd postoperatively in both groups(P0.05)while it significantly improved in ODL group at last follow up.Minimal complications were reported in both groups. CONCLUSIONS: Both ACDF and ODL are effective treatment for multilevel cervical spondylotic myelopathy with no significant difference between the two groups in Nurick grade, JOA score,recovery rate and MRI sagittal canal diameter widening.However, ODL group showed significant better cervical motion at last follow up but unfortunately,longer operative time and more blood loss.

Background: Using anterior or posterior surgery for multilevel cervical spondylotic myelopathy continues to be the subject of considerable debate. Studies on the comparison of the 2 approaches are limited and few studies focus on anterior cervical discectomy and fusion (ACDF) versus open door laminoplasty(ODL). Study design: A prospective study. Objective: To compare the clinical outcomes, radiographic changes, and complications of patients with multilevel cervical spondylotic myelopathy who underwent ACDF and ODL in lordotic cervical spine. METHODS: We evaluated 40 patients (20 patients inthe ACDF group and 20 patients in the ODL group) at our institution from September 2005 to December 2008. They were followed up for minimum 2 years.The clinical outcomes(Nurick grade and JOA score), radiographic changes(x ray and MRI), and complications were compared between the 2 groups. RESULTS: ODL showed significant more operative time(155 min Vs 95 min)and more blood loss(438 ml Vs 215 ml)than ACDF.Both ACDF and ODL groups showed significant improvement in Nurick grade from 3.5 and 3.4 preoperatively to 1.85 and 1.95 respectively at last follow up(P0.05). Both groups significantly improved the JOA (P0.05)and recovery rate(RR) was similar(63.2% in ACDF group and 64.4% in ODL group) (P0.05).The cervical motion (on dynamic lateral x-ray)significantly decreasd postoperatively in both groups(P0.05)while it significantly improved in ODL group at last follow up.Minimal complications were reported in both groups. CONCLUSIONS: Both ACDF and ODL are effective treatment for multilevel cervical spondylotic myelopathy with no significant difference between the two groups in Nurick grade, JOA score,recovery rate and MRI sagittal canal diameter widening.However, ODL group showed significant better cervical motion at last follow up but unfortunately,longer operative time and more blood loss.

Abstract Study design This is a prospective observational study. Purpose The aim of this study was to determine whether the combination of thoracoscopically assisted corpectomy with posterior percutaneous transpedicular instrumentation in prone position achieves treatment goals in burst thoracic or thoracolumbar fractures and minimizes the associated morbidities. Methods Between December 2007 and December 2008, 26 patients with acute burst spinal fractures were operated upon in our hospital. Those patients underwent posterior percutaneous stabilization plus anterior thoracoscopically assisted corpectomy and fusion in prone position. Clinical and radiological outcomes of these patients were evaluated after a minimum follow-up period of 2 years. The Oswestry Disability Index (ODI) combined with clinical examination was used for clinical evaluation. Plain X-ray in two views was used for the radiological evaluation. Results The mean operative time was 248 min. The average blood loss was 765 ml. Ten patients had preoperative neurological deficits ranging from Frankel A to D. One patient did not show any neurological improvement at the final follow-up. The mean ODI at final follow-up was about 7. The mean preoperative kyphosis angle was 25.58, improved to 9.2 postoperatively and to 13.8 at the final follow-up. No cases of implant failure were reported at the final follow-up. Conclusions Minimal invasive spinal techniques including thoracoscopic decompression and fusion and short segment posterior percutaneous instrumentation showed good clinical outcomes and can be considered as alternative to open procedures with decreased rates of morbidities

Abstract Study design This is a prospective observational study. Purpose The aim of this study was to determine whether the combination of thoracoscopically assisted corpectomy with posterior percutaneous transpedicular instrumentation in prone position achieves treatment goals in burst thoracic or thoracolumbar fractures and minimizes the associated morbidities. Methods Between December 2007 and December 2008, 26 patients with acute burst spinal fractures were operated upon in our hospital. Those patients underwent posterior percutaneous stabilization plus anterior thoracoscopically assisted corpectomy and fusion in prone position. Clinical and radiological outcomes of these patients were evaluated after a minimum follow-up period of 2 years. The Oswestry Disability Index (ODI) combined with clinical examination was used for clinical evaluation. Plain X-ray in two views was used for the radiological evaluation. Results The mean operative time was 248 min. The average blood loss was 765 ml. Ten patients had preoperative neurological deficits ranging from Frankel A to D. One patient did not show any neurological improvement at the final follow-up. The mean ODI at final follow-up was about 7. The mean preoperative kyphosis angle was 25.58, improved to 9.2 postoperatively and to 13.8 at the final follow-up. No cases of implant failure were reported at the final follow-up. Conclusions Minimal invasive spinal techniques including thoracoscopic decompression and fusion and short segment posterior percutaneous instrumentation showed good clinical outcomes and can be considered as alternative to open procedures with decreased rates of morbidities

Abstract Study design This is a prospective observational study. Purpose The aim of this study was to determine whether the combination of thoracoscopically assisted corpectomy with posterior percutaneous transpedicular instrumentation in prone position achieves treatment goals in burst thoracic or thoracolumbar fractures and minimizes the associated morbidities. Methods Between December 2007 and December 2008, 26 patients with acute burst spinal fractures were operated upon in our hospital. Those patients underwent posterior percutaneous stabilization plus anterior thoracoscopically assisted corpectomy and fusion in prone position. Clinical and radiological outcomes of these patients were evaluated after a minimum follow-up period of 2 years. The Oswestry Disability Index (ODI) combined with clinical examination was used for clinical evaluation. Plain X-ray in two views was used for the radiological evaluation. Results The mean operative time was 248 min. The average blood loss was 765 ml. Ten patients had preoperative neurological deficits ranging from Frankel A to D. One patient did not show any neurological improvement at the final follow-up. The mean ODI at final follow-up was about 7. The mean preoperative kyphosis angle was 25.58, improved to 9.2 postoperatively and to 13.8 at the final follow-up. No cases of implant failure were reported at the final follow-up. Conclusions Minimal invasive spinal techniques including thoracoscopic decompression and fusion and short segment posterior percutaneous instrumentation showed good clinical outcomes and can be considered as alternative to open procedures with decreased rates of morbidities

Abstract Study design This is a prospective observational study. Purpose The aim of this study was to determine whether the combination of thoracoscopically assisted corpectomy with posterior percutaneous transpedicular instrumentation in prone position achieves treatment goals in burst thoracic or thoracolumbar fractures and minimizes the associated morbidities. Methods Between December 2007 and December 2008, 26 patients with acute burst spinal fractures were operated upon in our hospital. Those patients underwent posterior percutaneous stabilization plus anterior thoracoscopically assisted corpectomy and fusion in prone position. Clinical and radiological outcomes of these patients were evaluated after a minimum follow-up period of 2 years. The Oswestry Disability Index (ODI) combined with clinical examination was used for clinical evaluation. Plain X-ray in two views was used for the radiological evaluation. Results The mean operative time was 248 min. The average blood loss was 765 ml. Ten patients had preoperative neurological deficits ranging from Frankel A to D. One patient did not show any neurological improvement at the final follow-up. The mean ODI at final follow-up was about 7. The mean preoperative kyphosis angle was 25.58, improved to 9.2 postoperatively and to 13.8 at the final follow-up. No cases of implant failure were reported at the final follow-up. Conclusions Minimal invasive spinal techniques including thoracoscopic decompression and fusion and short segment posterior percutaneous instrumentation showed good clinical outcomes and can be considered as alternative to open procedures with decreased rates of morbidities

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