Does mesh cage subsidence have any effect on functional outcome in spinal tuberculosis?

Tushar Rathod; Abhinav Jogani; Nandan Marathe; Kalaivanan Masilamani; Chetan Shende; Prashant Kamble

doi:10.4103/ajns.AJNS_261_19

Asian Journal of Neurosurgery, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(04): 1168-1174
DOI: 10.4103/ajns.AJNS_261_19

Original Article

Does mesh cage subsidence have any effect on functional outcome in spinal tuberculosis?

Autor*innen

Tushar Rathod

⁰Department of Orthopaedics, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra
Abhinav Jogani

⁰Department of Orthopaedics, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra
Nandan Marathe

⁰Department of Orthopaedics, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra
Kalaivanan Masilamani

⁰Department of Orthopaedics, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra
Chetan Shende

⁰Department of Orthopaedics, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra
Prashant Kamble

⁰Department of Orthopaedics, Seth GS Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra

Abstract

Introduction: Occurrence of mesh cage subsidence in patients undergoing anterior column reconstruction following Tuberculosis spine is frequent radiological finding as bone quality of affected vertebrae is poor. This study aims at determining effect of mesh cage subsidence on functional outcome. Methods: Retrospective demographics of 30 patients of consecutive series in age range 4-60 year were collected with Clinical outcome evaluation using VAS, ODI and ASIA scale. 30 patient having Dorsolumbar tuberculosis with vertebral involvement ranging from 1-6 with mean vertebral level involvement of 2.71, underwent anterior column reconstruction through posterior only approach between 2011-15 were reviewed. Patients were followed at regular intervals of 6 weeks, 12 weeks, 6 months & thereafter on yearly basis. They were evaluated for interbody height loss with subsidence, fusion & segmental angle. Results: Clinical parameters i.e. VAS & ODI showed improvement in postoperative period which continued to remain same even after subsidence (P < 0.05). Subsidence was categorized as combined anterior + posterior < 5mm; 5 -10mm; >10mm. ODI at follow up was 8.5 ±4.62, 9 ± 2 and 9 ± 4.2 (P = 0.961) respectively & VAS score in above group was 1.3 ± 0.51, 1.5 ± 1.2 & 1.5 ± 0.7 (P = 0.975) respectively. Subsidence was age, spinal level nonspecific. Conclusion: Study indicates that though Cage subsidence occurs to varying severity due to weakened vertebral bodies, it did not have significant impact on functional outcome in terms of VAS, ODI or radiological evidence of fusion following reconstruction in Spinal tuberculosis.

Key-words:

Cage subsidence - mesh cage - spinal tuberculosis

Volltext

Referenzen

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