Objective To assess clinical outcomes of surgical management of adults with thoracic and lumbar tuberculosis in Tibet by comparing posterior only, anterior only, and combined posterior and anterior surgical approaches. Methods The medical records for 62 patients treated for thoracic and lumbar tuberculosis between January 2010 and September 2018 were retrospectively reviewed. Among them, 28 patients were treated with single-stage anterior debridement and interbody fusion with instrumentation (Group A), 11 patients with posterior instrumentation, anterior debridement, and bone graft in a single or two-stage procedure (Group B), and 23 patients with posterior debridement and strut grafting with instrumentation (Group C). Operative time, blood loss, Visual Analog Scale score (VAS), complications, recovery of neurological function, Cobb angle, correction rate, and loss angle were compared among all groups. Results The patients were followed for 5-96 months, with an average of (10±5) months. The operative time of Group C [(213.5±42.3) min] was significantly shorter than that of Groups A [(260.9±58.1) min] and B [(292.7±45.2) min] (P 0.05). There was no statistically significant between groups in length of stay (P>0.05). The correction rate was superior in Groups B [(73.4±11.2)%] and C [(72.5±13.4)%] compared with Group A [(45.2±16.8)%], whereas the VAS score showed no statistically significant difference among the groups (P>0.05). Two patients developed recurrence 4 and 7 months after operation, one in Group A and one in Group B. During the operation, there were five cases of pleura rupture leading to hemopneumothorax (3 in Group A and 2 in Group B) and two cases of peritoneum rupture in Group B. Conclusion For patients with thoracic and lumbar tuberculosis, the use of single-stage anterior debridement and interbody fusion with instrumentation approach is limited for the unsatisfactory corrective effect and high complications. Although the combined approach produces satisfactory outcomes, it remains more traumatic and is associated with longer operative time and more blood loss. Therefore, the posterior approach is recommended, not only because it achieves good results, but also because it has reduced complications, shorter operative time, and less blood loss. Key words: Tuberculosis, spinal; Surgical procedures, operative; Treatment outcome; Complications

[目的]通过Meta分析系统评价胫骨高位截骨术(high tibial osteotomy,HTO)与单髁置换术(unicompartmental knee arthroplasty,UKA)治疗单间室骨性关节炎的疗效.[方法]通过计算机检索建库至2017年9月PubMed、Embase、Cochrane Library、CBM、CNKI、万方数据库,查找所有比较胫骨高位截骨和单髁置换治疗膝关节单间室骨关节炎的临床对照试验,根据纳入与排除标准进行文献筛选、质量评价和数据提取后,应用Revman 5.3软件对各项评价指标进行Meta分析.[结果]共纳入16篇文献,共6 488例膝关节,其中1 025例HTO,5 463例UKA.Meta分析结果显示:HTO与UKA相比,优良率[OR=0.33,95％CI:(0.16,0.70),P=0.004]、术后并发症[OR=3.07,95％CI:(1.78,5.31),P＜0.001]、术后疼痛[OR=0.34,95％CI:(0.19,0.59),P＜0.001]、术后关节活动度[MD=6.94,95％CI:(1.58,12.30),P=0.010]差异有统计学意义,返修率、术后膝关节评分、术后行走速度、术后股骨胫骨角差异无统计学意义.[结论] UKA相对HTO存在术后优良率较高、术后并发症较少的优势,HTO在术后疼痛及关节活动度上有优势;翻修率、膝关节评分、行走速度、股骨胫骨角HTO与UKA基本相似.但限于纳入文献的数量和质量,上述结论仍需更多大样本、高质量的RCT研究进一步论证.