DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20185331

Thoraco lumbar spinal tuberculosis-assessment of functional outcome following posterior decompression and posterior instrumentation

Shanmuga Sundaram Pooswamy, Niranjanan Raghavn Muralidharagopalan

Abstract


Background: Spinal tuberculosis is the most common form of extra pulmonary tuberculosis. Complications of untreated spinal tuberculosis include neurological deficit and gibbus deformity. Treatment of spinal TB can be surgical or conservative. Surgical treatment is the mainstay in spinal tuberculosis with neurological deficit. Various approaches to surgical management are anterior only, combined anterior & posterior and posterior only. Posterior only approach is less traumatic and more familiar to orthopaedicians.

Methods: 23 patients diagnosed of spinal tuberculosis with neurological involvement who underwent single stage posterior decompression and posterior stabilization were analyzed with ASIA grading and VAS score..

Results: The mean age of the study population was 48.86. There were 12 females and 11 males. The mean operative time and blood loss were 152.19 minutes and 265 ml. Increasing age correlated with blood loss and operating time. The mean follow up period was 36.21 months. There were significant differences in the ASIA and the VAS scores when pre-operative, immediate post-op and final follow up where compared.

Conclusions: Single stage posterior decompression and instrumentation is a safe and effective procedure in the treatment of tuberculous spondylodiscitis with neurological deficit and a kyphotic angle <60o. The long-term results are better because of posterior instrumentation, which provide stability and the healing anteriorly following antituberculous treatment.


Keywords


Spinal tuberculosis, Posterior only approach, Posterior stabilization, Posterior decompression

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