To investigate the clinical outcome of two different surgical approaches in the treatment of thoracolumbar spinal tuberculosis in elderly patients.

A retrospective study was performed on 124 patients with thoracolumbar spinal tuberculosis who underwent two different surgical approaches in the second hospital of Anhui Medical University form January 2013 to December 2019. Patients were divided into two groups according to the different surgical approaches: Anterior approach group (n=63) were treated by anterior surgical approach, and posterior approach group (n=61) were treated by posterior surgical approach. Meanwhile, the operation time, intra-operative blood loss, hospitalization time, Cobb'angle, ESR, CRP, VAS, and ODI were compared between the two groups.

There was no significant difference between the two groups in terms of operation time, intra-operative blood loss and hospitalization time (P>0.05), and there was significant difference between the two groups in ESR, CRP, VAS and ODI per-operatively and final follow-up. At the final follow-up, the post-operative Cobb's angle of anterior approach group was higher than that of posterior approach group showing significantly difference (P<0.05). No complications of recurrence of spinal tuberculosis, and no complications of infection, deep vein thrombosis, nonunion or delayed union was observed.

These two different surgical approaches for thoracolumbar spinal tuberculosis showed good clinical outcome in elderly patients, and the posterior approach is better for the correction of kyphosis.