RSS-Feed abonnieren
DOI: 10.1055/s-0042-1750834
A Prospective Observational Study on Outcomes of Single Stage Posterior Decompression and Fixation for Dorsolumbar Spine Tuberculosis
Artikel in mehreren Sprachen: português | English Financial Support There was no financial support from public, commercial, or non-profit sources.
Abstract
Objective To study the results of only posterior decompression and instrumentation in dorsal and dorsolumbar spine tuberculosis.
Methods The patients (n = 30) who were included in this study had dorsal or dorsolumbar spine tuberculosis, with or without neurological deficit, and with or without deformity. All 30 patients were managed by only posterior approach decompression and instrumentation. We studied cases for correction and maintenance of deformity at dorsal and dorsolumbar spine, functional outcome by the Oswestry disability index (ODI) and visual analogue scale (VAS) scores, as well as neurological outcome by the Frankel grade.
Results In the current series, 30 patients were operated with single stage posterior decompression and instrumentation, and showed significant improvement in neurological status and functional outcomes, which were accessed by the ODI score, VAS score, and Frankel grade.
Conclusion The posterior (extracavitary) approach provides optimum access to the lateral and anterior aspects of the spinal cord for good decompression. It facilitates early mobilization and avoids problems of prolonged recumbency, provides better functional outcome, and significantly better sagittal plane kyphosis correction.
Publikationsverlauf
Eingereicht: 03. Februar 2022
Angenommen: 28. April 2022
Artikel online veröffentlicht:
14. Juli 2022
© 2022. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
Referências
- 1 Tuli SM. Tuberculosis of the skeletal system. 6th ed. New Delhi: Jaypee Brothers Medical Pub; 2020
- 2 Jain AK, Dhammi IK, Prashad B, Sinha S, Mishra P. Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach. J Bone Joint Surg Br 2008; 90 (11) 1477-1481
- 3 Garg RK, Somvanshi DS. Spinal tuberculosis: a review. J Spinal Cord Med 2011; 34 (05) 440-454
- 4 Hee HT, Majd ME, Holt RT, Pienkowski D. Better treatment of vertebral osteomyelitis using posterior stabilization and titanium mesh cages. J Spinal Disord Tech 2002; 15 (02) 149-156 , discussion 156
- 5 Goel MK. Treatment of Pott's paraplegia by operation. J Bone Joint Surg Br 1967; 49 (04) 674-681
- 6 Seddon HJ. Pott's paraplegia: prognosis and treatment. Br J Surg 1934; 22 (88) 769-799
- 7 Donaldson JR, Marshall CE. Pott's disease (Experience with 560 operated cases). Indian J Surg 1965; 27: 765-773
- 8 Lee TC, Lu K, Yang LC, Huang HY, Liang CL. Transpedicular instrumentation as an adjunct in the treatment of thoracolumbar and lumbar spine tuberculosis with early stage bone destruction. J Neurosurg 1999; 91 (2, Suppl) 163-169
- 9 Standring S. Gray's anatomy. The anatomical basis of clinical practice. 39th ed. Philadelphia: Churchill Livingstone; 2004
- 10 Hodgson AR, Stock FE. Anterior spinal fusionfor the treatment of tuberculosis of spine. J Bone Joint Surg 1960; 42 (02) 295-310
- 11 Moon MS. Tuberculosis of the spine. Controversies and a new challenge. Spine 1997; 22 (15) 1791-1797
- 12 Rajasekaran S, Soundarapandian S. Progression of kyphosis in tuberculosis of the spine treated by anterior arthrodesis. J Bone Joint Surg Am 1989; 71 (09) 1314-1323
- 13 Sundararaj GD, Behera S, Ravi V, Venkatesh K, Cherian VM, Lee V. Role of posterior stabilisation in the management of tuberculosis of the dorsal and lumbar spine. J Bone Joint Surg Br 2003; 85 (01) 100-106
- 14 A controlled trial of débridement and ambulatory treatment in the management of tuberculosis of the spine in patients on standard chemotherapy. A study in Bulawayo, Rhodesia. J Trop Med Hyg 1974; 77 (04) 72-92
- 15 Shah M, Suthar K, Zala R. To study the outcomes of posterior decompression and fixation of tuberculosis of dorsolumbar spine. Int J Orthop Sci 2017; 3 (03) 691-695
- 16 Zeng H, Zhang P, Shen X. et al. One-stage posterior-only approach in surgical treatment of single-segment thoracic spinal tuberculosis with neurological deficits in adults: a retrospective study of 34 cases. BMC Musculoskelet Disord 2015; 16: 186
- 17 Islam MF, Akon MSI, Alom MI, Islam MZU, Hossain MY, Hossain MI. Evaluation of Outcome of Decompression and Transpedicular Screw Fixation in the Management of TB of the Thoracolumbar Spine. Med Today (Karachi) 2020; 32 (02) 104-111 cited 2022 Apr. 26 [Internet] from https://www.banglajol.info/index.php/medtoday/article/view/48823
- 18 Patidar AB, Mehta RP, Sharma SK, Vyas GB, Singh V, Ramchandra O. Single-stage posterior-only debridement and transpedicular screw fixation for dorsolumbar tuberculosis: A prospective study of twenty cases. J Orthop Allied Sci 2017; 5: 74 DOI: 10.4103/joas.joas_11_17.