• Sayed Abdulla Jami Department of Spinal Surgery, General Hospital of Ningxia Medical University, Ningxia, People’s Republic of China
  • Shi Jiandang Department of Spinal Surgery, General Hospital of Ningxia Medical University, Ningxia, People’s Republic of China
  • Zhanwen Zhou Department of Spinal Surgery, General Hospital of Ningxia Medical University, Ningxia, People’s Republic of China
  • Liu Chang Hao Department of Spinal Surgery, General Hospital of Ningxia Medical University, Ningxia, People’s Republic of China
Keywords: review, current, advance, surgical approaches, spinal tuberculosis


Spinal tuberculosis (TB), caused by mycobacterium tuberculosis, is one of the oldest diseases in the world. Spinal TB represents 50% of bone and joint TB. If spinal TB is not diagnosed and treated in time, it could cause spinal cord infection, nerve compression and paralysis.  Spinal TB often causes abscesses formation, spinal dysfunction, spinal instability, and kyphosis onset disorder. Most spinal TB can be cured by non-surgical treatment. Surgery is the ultimate method of treatment of spinal tuberculosis and it is used for eliminating lesions, relieving spinal cord and nerve compression, correcting kyphosis and building spine stability. At present, spinal TB surgical approaches are mainly posterior approach, combined anterior-posterior approach and minimally invasive techniques. The present review summarizes the advantages, disadvantages and indications for each surgical method.


[1] T. Shi et al., "Retrospective Study of 967 Patients with Spinal Tuberculosis," Orthopedics, vol. 39, no. 5, pp. e838-e843.
[2] R. Jain, S. Sawhney, and M. Berry, "Computed tomography of vertebral tuberculosis: patterns of bone destruction," vol. 47, no. 3, p. 196, 1993.
[3] S. Dureja, I. B. Sen, and S. Acharya, "Potential role of F18 FDG PET-CT as an imaging biomarker for the noninvasive evaluation in uncomplicated skeletal tuberculosis: a prospective clinical observational study," (in eng), Eur Spine J, vol. 23, no. 11, pp. 2449-54, Nov 2014.
[4] X. Wang, X. Pang, P. Wu, C. Luo, and X. Shen, "One-stage anterior debridement, bone grafting and posterior instrumentation vs. single posterior debridement, bone grafting, and instrumentation for the treatment of thoracic and lumbar spinal tuberculosis," European Spine Journal, vol. 23, no. 4, pp. 830-837.
[5] Z. Xu et al., "Posterior only versus combined posterior and anterior approaches for lower lumbar tuberculous spondylitis with neurological deficits in the aged," Spinal Cord, vol. 53, no. 6, pp. 482-487.
[6] X. Shen, H. Liu, G. Wang, and X. Liu, "Single-stage posterior-only approach treating single-segment thoracic tubercular spondylitis," International Journal of Clinical & Experimental Pathology, vol. 8, no. 9, pp. 11051-11059, 2015.
[7] X. H. Yin et al., "The role of costotransverse radical debridement, fusion and postural drainage in the surgical treatment of multisegmental thoracic spinal tuberculosis: a minimum 5-year follow-up," European Spine Journal, vol. 25, no. 4, pp. 1047-1055.
[8] J Liu,L Wan,X Long,et al. Efficacy and safety of posterior versus combined posterior and anterior approach for the treatment of spinal tuberculosis :a meta-analysi[J]. World Neurosurg,2015,83(6):1157-1165.
[9] A. Jain, I. Dhammi, B. Prashad, S. Sinha, and P. Mishra, "Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach," The Journal of bone and joint surgery. British volume, vol. 90, no. 11, pp. 1477-1481, 2008.
[10] K. C. Mak and K. M. C. Cheung, "Erratum to: Surgical treatment of acute TB spondylitis: indications and outcomes," European Spine Journal, vol. 22, no. 1, pp. 211-211.
[11] M. He, H. Xu, J. Zhao, and Z. Wang, "Anterior debridement, decompression, bone grafting, and instrumentation for lower cervical spine tuberculosis," Spine Journal, vol. 14, no. 4, pp. 619-627.
[12] Li et al., "One-stage surgical management for thoracic tuberculosis by anterior debridement, decompression and autogenous rib grafts, and instrumentation," vol. 11, no. 8, pp. 726-733, 2011.
[13] P. Liu, M. Sun, S. Li, Z. Wang, and G. Ding, "A retrospective controlled study of three different operative approaches for the treatment of thoracic and lumbar spinal tuberculosis: Three years of follow-up," Clinical Neurology & Neurosurgery, vol. 128, pp. 25-34.
[14] H. Zeng et al., "Comparison of three surgical approaches for cervicothoracic spinal tuberculosis: a retrospective case-control study," vol. 10, no. 1, pp. 1-10, 2015.
[15] K. Hassan and E. Elmorshidy, "Anterior versus posterior approach in surgical treatment of tuberculous spondylodiscitis of thoracic and lumbar spine," European Spine Journal, vol. 25, no. 4, pp. 1056-1063.
[16] T. Ling, L. Liu, X. Yang, Z. Qiang, X. Hu, and Y. An, "Revision surgery for spinal tuberculosis with secondary deformity after treatment with debridement, instrumentation, and fusion," European Spine Journal, vol. 24, no. 3, pp. 577-585.
[17] Z. Liu, L. Jiaming, P. Aifeng, L. Xinhua, Y. Dong, and H. Shanhu, "One-Stage Posterior Debridement and Transpedicular Screw Fixation for Treating Monosegmental Thoracic and Lumbar Spinal Tuberculosis in Adults," The Scientific World Journal, vol. 2014, pp. 1-6.
[18] H. L. Frankel et al., "The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia," vol. 7, no. 3, pp. 179-192.
[19] L. Wang, H. Zhang, M. Tang, Q. Gao, Z. Zhou, and X. Yin, "Comparison of Three Surgical Approaches for Thoracic Spinal Tuberculosis in Adult," vol. 42, no. 11, pp. 808-817, 2017.
[20] H. Q. Zhang et al., "One-stage posterior debridement, transforaminal lumbar interbody fusion and instrumentation in treatment of lumbar spinal tuberculosis: a retrospective case series," Archives of Orthopaedic & Trauma Surgery, vol. 133, no. 3, pp. 333-341, 2013.
[21] H. Zhang, K. Zeng, X. Yin, J. Huang, M. Tang, and C. Guo, "Debridement, internal fixation, and reconstruction using titanium mesh for the surgical treatment of thoracic and lumbar spinal tuberculosis via a posterior-only approach: a 4-year follow-up of 28 patients," Journal of Orthopaedic Surgery & Research, vol. 10, no. 1, p. 150.
[22] X. Yin, P. Liu, Y.-y. Liu, W.-L. Fan, B.-y. Liu, and J.-H. Zhao, "Utilization of ring-shaped bone allograft for surgical treatment of adolescent post-tubercular kyphosis," Medicine, vol. 96, no. 24, p. e7132.
[23] Y. Gao, Y. Ou, Q. Deng, B. He, X. Du, and J. Li, "Comparison between titanium mesh and autogenous iliac bone graft to restore vertebral height through posterior approach for the treatment of thoracic and lumbar spinal tuberculosis," (in eng), PLoS One, vol. 12, no. 4, p. e0175567, 2017.
[24] H. Ky, Y. Chung, and S. Ryoo, "Adherence and biofilm formation of Staphylococcus epidermidis and Mycobacterium tuberculosis on various spinal implants," Spine, vol. 30, no. 1, pp. 38-43, 2005.
[25] Z. Wang, H. Yuan, G. Geng, J. Shi, and W. Jin, "Posterior mono-segmental fixation, combined with anterior debridement and strut graft, for treatment of the mono-segmental lumbar spine tuberculosis," vol. 36, no. 2, pp. 325-329.
[26] Z. Wang, Q. Wu, and G. Geng, "Anterior debridement and bone grafting with posterior single-segment internal fixation for the treatment of mono-segmental spinal tuberculosis," Injury, vol. 44, no. 2, pp. 253-257, 2013.
[27] N. Garg and R. Vohra, "Minimally invasive surgical approaches in the management of tuberculosis of the thoracic and lumbar spine," Clinical Orthopaedics and Related Research®, vol. 472, no. 6, pp. 1855-1867, 2014.
[28] G. Lü, B. Wang, J. Li, W. Liu, and I. Cheng, "Anterior debridement and reconstruction via thoracoscopy-assisted mini-open approach for the treatment of thoracic spinal tuberculosis: minimum 5-year follow-up," vol. 21, no. 3, pp. 463-469.
How to Cite
Jami, S., Jiandang, S., Zhou, Z., & Hao, L. (2020). REVIEW OF THE SPINAL TUBERCULOSIS SURGICAL TREATMENT AND OUTCOMES. Romanian Journal of Clinical Research, 3(1), 24-30.