Shehzad Javed, Asif Saeed, Amer Aziz.
Comparative study of anterior decompression for caries spine using strut graft with and without instrumentation (moss miami).
J Pak Orthop Assoc Jan ;20(1):55-9.

Objective: To compare the rate of graft slippage in patients managed by anterior decompression with strut graft and instrumentation using Moss Miami System and patients treated by strut graft only. Study Design: Quasi-experimental. Place and Duration of Study: The study was conducted in Orthopedics ward, Ghurki (Trust) Teaching Hospital, Lahore, from January 2004 to December 2004. Patients and Methods: Thirty-patients between 15 to 60 years of age of either sex with no previous spinal surgery having spinal tuberculosis from D7-L5 vertebrae were included. Patients were divided into groups A and B, having 15 patients in each. Group A patients were managed with strut graft and instrumentation using Moss Miami system. Group B patients were treated by strut graft only. Results: Results were evaluated for clinical and radiological data. We were able to complete the follow-up of all the patients, which showed that physical and radiological findings were helpful in concluding definite decision of the cases. Complete neurological recovery was seen in 88% with an average duration of recovery of eight months. The duration and extent of neurological recovery was related to the chronicity of the disease and neurological status of the patient at the time of operation. Regarding the final outcome of grafting, Group A was stable throughout the follow-up. At the 4th month in group B, one patient was found to have a partial slippage of graft (50% slippage) out of 3 patients and at the 5th month again one patient had partial slippage of graft. In the group B, at the end of 6th month, one patient was having a complete slippage of graft (i.e. the graft was not confined) and 2 patients showed partial graft slippage (50% slippage) and 12 patients were stable. Conclusion: We conclude that graft with instrumentation is more effective than only graft for reducing the deformity and stabilizing the vertebral column in patients who have tuberculosis of the spine.

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