Description
- Abstract:
- Background Spinal tuberculosis (Pott Disease) frequently leads to vertebral destruction, kyphotic deformity, and neurological impairment. While antitubercular chemotherapy remains the cornerstone of treatment, surgery is the primary intervention in cases of progressive deformity, instability, or medical treatment failure. The choice between anterior and posterior surgical approaches currently lacks consensus. We conducted a systematic review comparing clinical, radiographic, and perioperative outcomes between anterior and posterior surgical approaches for the management of spinal tuberculosis. Methods A systematic review following PRISMA guidelines was conducted using PubMed, Embase, and regional databases through March 2025. Of the 2,523 articles screened, 28 retrospective or prospective comparative studies from China, India, Egypt and Japan met inclusion criteria. Studies without primary operative outcomes, animal data, or direct anterior versus posterior comparisons were excluded. In total, 1,628 patients were analyzed (702 anterior, 926 posterior). Random-effects meta-analysis was used. Outcomes included kyphotic correction, neurological recovery (ASIA/Frankel grade), complication rates, operative metrics, and hospital stay. Results The posterior approach was associated with significantly better preservation of kyphotic correction angles (2.8° posterior vs 3.9° anterior, p = 0.007) and a shorter hospital stay (21.9 vs 32.9 days, p = 0.141). No statistical differences were observed in complication rates (23% vs 34%), wound infections (6.3% vs 7.5%), neurological recovery either postoperatively (77% vs 70%) or at final follow-up (76% vs 72%), operative duration, blood loss, fusion rates, or mortality (<0.5% in both groups) Conclusion Posterior approaches demonstrated significantly improved maintenance of deformity correction and shorter hospital stays. However, the clinical relevance of these findings may be multifactorial and influenced by surgeon preference, region, or case selection. Posterior fixation offers benefits in selected patients, but further studies are needed to define the optimal surgical strategy for spinal tuberculosis.
Access Conditions
- Use and Reproduction
- All rights reserved
- Rights
- In Copyright
- Restrictions on Use
- All Rights Reserved
Citation
Akinwunmi-Williams, Timi , Glover, Banahene , Garner Jarius , Holzer, Joey , Jobe, Awa, Darko, Kwadwo, Serhat, Aydin, Barrie Umaru,
"Comparative Outcomes of Anterior versus Posterior Surgery for Spinal Tuberculosis (Pott Disease): A Global Systematic Review and Meta-analysis"
(2025).
Student Neurosurgery/Neurology Research Conference.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/twd6-4357
Relations
Collection:
-
Student Neurosurgery/Neurology Research Conference
Brown University Department of Neurosurgery and Department of Neurology and Warren Alpert Medical School annually hosts the Student Neurosurgery/Neurology Research Conference, a national conference for medical students conducting research in neurosurgery/neurology or related neuroscience fields....