Surgical Management and Clinical Outcomes of Spinal Tuberculosis: A Systematic Review and Meta-analysis on Current Concepts and Strategies
DOI:
https://doi.org/10.56929/jseaortho-2026-0317Keywords:
Spinal tuberculosis, anterior approach, posterior approach, laminectomy, decompression, spinal fusion and clinical outcomes, Pott’s diseaseAbstract
Background: Spinal tuberculosis, also known as Pott’s disease, accounts for nearly half of all musculoskeletal tuberculosis cases and is the most common form in children and young adults. Its incidence is increasing in developed countries. This study aimed to evaluate surgical outcomes, from percutaneous biopsy to anterior and posterior spinal decompression, in patients with spinal tuberculosis and kyphosis through different surgical procedures and the expectation of clinical outcomes.
Methods: A comprehensive search was conducted across ScienceDirect, PubMed/MEDLINE, and Google Scholar in accordance with the PRISMA guidelines. Statistical analysis was performed using R statistical software and Excel (PROSPERO REGISTRATION NUMBER: CRD420261327294). The search terms included “spinal tuberculosis” and its management, surgical techniques, and associated outcomes related to morbidity and mortality, as well as related pathologies. Inclusion criteria were limited to English-language studies published between January 2012 and September 2025.
Results: In this review, a total of 2,710 patients with spinal tuberculosis were identified. Of these, 1,010 patients (37%) were analyzed for surgical approach; 439 (16%) underwent a posterior approach, and 554 (20%) underwent an anterior approach. Regarding diagnostic methods, among 1,700 patients (63%), 867 (32%) underwent histopathological examination, 1,211 (44%) had smear testing, and 858 (31%) were tested using GeneXpert.
Conclusions: Spinal tuberculosis remains complex in both diagnosis and surgical management. Well-executed anterior or posterior approaches are effective for kyphosis correction and spinal cord decompression. However, biopsy performed post-laminectomy through paravertebral or multifidus muscle incisions carries a higher risk of sample contamination compared with alternative techniques.
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