Comparison of bundled rib implants and titanium mesh implants in thoracic spinal tuberculosis surgery

Abstract Objective: This study aimed to compare bundled multifracture rib implants and titanium mesh implants for thoracic spinal tuberculosis using the transverse costal approach. Methods: Patients with thoracic spinal tuberculosis were divided into two groups. Both groups underwent surgery via the transverse costal approach. After removal of the necrotic tissue from the tuberculosis lesion, group A received titanium mesh bone grafts and group B received bundled rib bone grafts. Bone grafting time, blood loss during surgery, Cobb angle correction after surgery, loss of Cobb angle after the last follow-up, and bone graft fusion time were compared between the two groups. Results: Thirty-eight patients (n = 19 per group) were included in this study. The follow-up duration was 24–42 months. The mean operative time was significantly longer in group A than in group B (154.63 ± 15.48 min vs. 130.95 ± 25.51 min, t = 3.460, P = 0.001). Implant fusion time, intraoperative bleeding volume, and preoperative Cobb angle were not significantly different between the two groups (7.11 ± 0.46 months vs. 7.16 ± 0.60 months, P > 0.05; 556.68 ± 116.76 ml vs. 518.63 ± 108.48 ml, P > 0.05; 36.47° ± 7.57° and 37.63° ± 6.45°, P > 0.05, respectively). After treatment, spinal nerve function recovered at least partially in both groups. The Oswestry dysfunction indices were not significantly different between the two groups (P > 0.05). Conclusion: Compared with the titanium mesh implant, the bundled rib implant is more convenient, has easy bone block implantation procedure, and requires shorter time for bone grafting. No differences in intraoperative blood loss, postoperative bone graft fusion time, and spinal nerve function recovery were detected. Furthermore, stabilization function is achieved earlier with the bundled rip implant after thoracic spinal tuberculosis lesion removal, supporting the use of this implant.