Abstract
Background Thoracolumbar spine constitutes the most common site for spinal tuberculosis. Though
the treatment of spinal tuberculosis is antitubercular drugs initially, the patient
with neurologic weakness warrants definitive surgical procedure of decompression and
stabilization. Even though many investigators have reported favorable results with
anterior decompression and stabilization surgery, due to the increased morbidity and
complications, the posterior-only approach with decompression and stabilization has
evolved as the operation of choice in recent time.
Methods All patients aged between 18 and 70 years with clinically and radiologically proven
symptomatic thoracolumbar spinal tuberculosis who failed with conservative treatment
for 4 weeks or developed neurologic weakness between the treatments are included in
this study. All patients were offered decompression and posterior stabilization with
transpedicular screws and rods after explaining the above procedure. Clinical outcome
was measured by modified Frankel grading; AIS (American Spinal Injury Association
impairment score) grade impairment score; and pain assessment done with visual analog
scale (VAS) pre- and postoperatively and at 3, 6, and 9 months of interval.
Results The postoperative pain relief, neurologic improvement as per modified Frankel grade,
AIS grade, and improvement in erythrocyte sedimentation rate and C-reactive protein
were significant as compared with the preoperative status. The surgical interventions
thus prove to have adequate relief to the patient and arresting the disease progression.
The surgical outcome has very minimal intra- and postoperative complications.
Conclusion Single-stage decompression and posterior stabilization in thoracolumbar spinal tuberculosis
is safe, effective, and results in good clinical outcome. The advantages of surgery
include thorough debridement, decompression, and achievement of spinal stabilization.
Keywords
tuberculosis - spine - decompression - posterior fixation
