Shams Raza Brohi, Ghulam Nabi Memon, Ali Raza Brohi, Manzor Lakhair, Rafique Ahmed Memon.
Experience with spinal instrumentation for Tuberculosis spine at PMCH Nawabshah
Med Channel Jan - Mar 2006;12(1):71-4.
Peoples Medical College Nawabshah, Sindh
INTRODUCTION: Spinal column is the common site of skeletal tuberculosis. Anteriorly there are three varieties: Paradiscal, Centrosomatic and Anterior Longitudinal. Extra-osseous involvement causes paravertebral abscess, epidural abscess or involvement of ligaments. The purpose of this study is to identify the frequency, presenting features, diagnostic tests and outcome of decompression and stabilization of tuberculous spondylitis. PATIENTS & METHODS: This study was conducted in Peoples Medical College, Nawabshah. All cases of spinal tuberculosis treated surgically were included. Admission criteria for these patients were advanced form of spinal tuberculosis, presenting with progressive deformity, neurological deficit, intractable pain, large paraspinal abscess or posterior element involvement. RESULTS: Over a period of 5 years, we had operated upon 248 cases of tuberculous spondylitis. Females dominated (1.91 times). Bulk of series belonged to younger age group less than 40 years. Majorities of them had pain, neurological deficit and gibbus deformity. Surgery was performed to decompress the cord, apply a bony strut graft and stabilize with instrumentation. Thoracic region was commonly involved. Anterior approach was preferred because most of times anterior elements were involved. Webb Morley instrumentation system was used in majority of cases from D4 to L4. At the end of 6 months postoperatively pain relief was observed in 94.9% and neurological (motor) improvement in 92.2% cases. CONCLUSION: In this series we have observed that in our part of the world tuberculosis of spine is commonly seen in females and younger age group. Anterior decompression and stabilization is helpful in segmental rigid fixation of spine, pain relief deformity correction and early neurological recovery.
Category: Neurosurgery
Keywords: Tuberculosis. Vertebral Column. Spondylitis. Webb Morley Instrumentation.
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