• Zheng Liu, Weiwei Li, Zhengchao Xu, Yilu Zhang, Yunqi Wu, Xiyang Wang, and Hao Zeng.
• Department of Spine Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China; Hunan Engineering Laboratory of Advanced Artificial Osteo-Materials, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
• World Neurosurg. 2020 Mar 1; 135: e468-e476.

ObjectiveTo investigate the clinical and imaging outcomes of posterior unilateral vertebral lamina fenestration debridement and bone grafting fusion combined with laminar reconstruction and instrumentation compared with the traditional posterior-only method for treating monosegment spinal tuberculosis.MethodsFifty-four patients underwent posterior unilateral vertebral lamina fenestration debridement and bone grafting fusion combined with laminar reconstruction and internal fixation (group A), and 60 patients underwent 1-stage posterior debridement, laminectomy decompression, bone grafting fusion and instrumentation (group B). The clinical and radiographic outcomes of these groups were analyzed and compared.ResultsGroup A had less intraoperative blood loss, shorter hospitalization, and a shorter fusion time than did group B (P < 0.05). At 3 months postoperatively, group A had a lower mean Oswestry Disability Index than did group B (P < 0.05). At the final follow-up, group A had a lower mean visual analog scale pain score and a lower mean ODI than did group B (P < 0.05). Group A had a smaller kyphotic angle loss (1.2° ± 0.6°) and loss rate (4.8% ± 2.5%) than did group B (P < 0.05).ConclusionsThe procedure of posterior unilateral vertebral lamina fenestration debridement and bone grafting fusion combined with laminar reconstruction and internal fixation is safe and effective in treating monosegment spinal tuberculosis. Compared with the conventional posterior-only approach, this method maximizes the retention and reconstruction of the posterior column and is minimally invasive, achieving faster postoperative recovery with fewer complications.Copyright © 2019 Elsevier Inc. All rights reserved.

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