Posterior fixation in dorsolumbar spine tuberculosis (study of 50 cases)

Dr. Harshadkumar A. Patel; Dr. Rajesh A. Solanki; Dr. Punit J. Tank; Dr. Mehul R. Chandana

Volume : V, Issue : V, May - 2016

Posterior fixation in dorsolumbar spine tuberculosis (study of 50 cases)

Dr. Harshadkumar A. Patel, Dr. Rajesh A. Solanki, Dr. Punit J. Tank, Dr. Mehul R. Chandana

Abstract :

Spine tuberculosis is anterior disease , it heals well with antitubercular therapy and for stability of spine we can support with simple posterior fixation. Anterior surgical approach needs expertise and it leads to many surgical related complication.We choose to go with posterior fixation to show results in combination with antituberculous drug.We have studied 60pateints with tuberculous spine with or without neurological involvement and with/without kyphotic deformity,out which 50patients were fully followed up. All patients were operate only with only posterior decompression and fixation. Their neurological status (Gertzbein grading),rate of fusion (Bridwell score),pain status (Denis pain–scale),functional ability (Denis work–scale)and final (Seybold and bayley score)was noted. Out of total 50patients, 27(54%)were males with average age of patients was 31–50 Years. 23(46%)patients had improvement of 1 grade in frankle grade and 17(34%)had improvement in the same frankle grade.8(16%)patients had no neurological improvement. 25(50%)had excellent outcome with 100% had correction of kyphosis post operatively. Patients with dorsal tuberculosis had an average score of 13.78and lumbar tuberculosis had better score 15.72.Posterior stabilization and reconstruction of spine by posterior and posterolateral fusion by bony approximation and in some cases fusion with cage helps in preventing progression of deformity.There was significant correction in angle of kyphosis immediate after posterior fixation.Among neurologically compromised patients, posterior fixation with posterior decompression had significantly increase recovery. Functional outcome was significantly better in posteriorly fixed group of patients with average score being 14.66.After posterior decompression and fixation, functional outcome is better in form of pain relief, work performance, fusion and neurological outcome.