Year : 2017  |  Volume : 5  |  Issue : 2  |  Page : 74-79

Single-stage posterior-only debridement and transpedicular screw fixation for dorsolumbar tuberculosis: A prospective study of twenty cases

Department of Orthopaedics, R. D Gardi Medical College, Ujjain, Madhya Pradesh, India

Correspondence Address:
Dr. Ashish Balkrishna Patidar
127 Amarnath Avenue, Indore Road, Ujjain - 456 001, Madhya Pradesh
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joas.joas_11_17

Rights and Permissions

BACKGROUND: India bears the highest burden of tuberculosis (TB), i.e., about one-fourth of the total burden. Of the musculoskeletal TB, spinal TB affects half of the patients. Pharmacological treatment in the form of AKT is the mainstay of treatment of spinal TB, but surgery has its own role to play as an adjunct to AKT in selected cases. Various surgical methods and approaches are mentioned in literature. We studied the efficacy and safety of posterior only approach for decompression and internal fixation in treating thoracic and lumbar spinal TB in adults. MATERIALS AND METHODS: In this prospective randomized control study, we treated twenty patients with thoracic-lumbar TB with single-stage posterior only debridement, decompression, and transpedicular screw fixation. Preoperative and postoperative C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), kyphosis angle, visual analog scale (VAS) score and Frankel neurological grading, intraoperative blood loss, and duration of surgery were compared. Correction in kyphosis angle and loss of kyphosis angle at final follow-up was assessed. RESULTS: Sixteen male and four female patients with mean age 37.9 years were treated. Average follow-up was 14.95 months. Thirteen patients had two level involved; seven had single level. The average duration of surgery was 155 min (standard deviation [SD] 23.951). Preoperative average increase in ESR was 39.4 mm/h (SD 9.046) and 24.15 mm/h (SD 3.787) at 3 weeks. Average preoperative CRP was 15.7 mg/L (SD 5.398) and 9.05 mg/L (SD 3.456) at 3 weeks. Average preoperative kyphosis angle was 24.7° (SD 6.822) corrected to an average of 10.1° (SD 3.932) postoperative. At final follow-up, there was a mean loss of 1.4° of kyphosis angle. The average blood loss was 722.75 ml; the average duration of surgery was 228.5 min. The pain VAS dropped significantly from 7.05 (SD 1.468) to 3.9 (SD 1.209). At final follow-up, VAS was 1.7 (SD 0.864). All the patients had good neurological recovery except one. CONCLUSIONS: Single-stage posterior-only procedure is safe and effective for management of thoracolumbar spinal TB.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded381    
    Comments [Add]    
    Cited by others 2    

Recommend this journal