IJOCP | March 2015| Volume 2| Issue 1 | Page Conference: Bangalore Orthopaedic Society Annual Conference BOSCON-2015,India[Click for Full details]
Authors: Yogesh Kumar B, SP Mohanty, Shyamasunder Bhat N, Sujatha.K
Authors Affiliations: Manipal Hospital
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Background: One of the important sites for extra pulmonary TB involvement is the skeleton. Tuberculous spondylitis (Pott’s disease) comprises 50-70% of the skeletal tuberculosis. Although surgical approaches for thoracic and thoracolumbar tuberculosis has been in dilemma, single stage posterior approach helps in adequate decompression of spinal cord, better kyphotic correction, sound interbody fusion thereby preventing late onset paraplegia.
AIM: To evaluate the results of single stage “Anterior decompression, posterior spinal instrumentation and global fusion through posterior approach in tuberculosis of spine” with regards to healing of the disease, correction and prevention of kyphotic deformity and early neurological recovery.
MATERIALS AND METHODS: 70 patients with thoracic and thoracolumbar spinal tuberculosis were operated by single stage posterior approach. They were followed for minimum of 2 years by clinical, hematological and radiological parameters.
RESULTS: In the thoracic group, the mean preoperative kyphotic angle was 48.4° (range 21.5°-65.2°) and the mean postoperative kyphotic angle was 22.1° (range 14.5°-27.4°).The mean correction of kyphotic deformity was 26.3° (Ρ < 0 .001).In the thoracolumbar group, the mean preoperative kyphotic angle was 57.5° (range 31.5°-72.2°) and the mean postoperative kyphotic angle was 25.7° (range 17.22°-31.6°). The mean correction of kyphotic deformity was 31.9° (Ρ < 0 .001).
Twenty nine of the patients presented with altered neurology, out of which 25 recovered to ASIA E at end of 2 years follow up. One patient with ASIA A recovered to ASIA C and 3 patients with ASIA B recovered to ASIA D.The interbody fusion started appearing at the end of 3 months and peaked at 1 year. The mean duration of sound interbody fusion in our study was 9 months (3 to 15 months).
CONCLUSION:Being a posterior approach, the surgery was found to be simpler and had less number of intraoperative complications.In our experience, with anterior debridement, posterior instrumentation and fusion followed by chemotherapy produced gratifying results in relation to healing of the disease, bony fusion, correction and prevention ofkyphosis, and thereby late onset paraplegia.
How to Cite this Abstract
Yogesh Kumar B, SP Mohanty, Shyamasunder Bhat N, Sujatha K. Single stage posterior spinal surgery alone for thoracic and thoraco-lumbar spinal tuberculosis.International Journal of Conference Proceedings. March 2015;(2015):14.