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Background: Pott’s disease is a rare form of extrapulmonary tuberculosis that manifests in a variety of clinical patterns. Delays in diagnosis and treatment can lead to serious complications. About 10-40% of patients with spinal tuberculosis may have a neurological deficit. Urgent measures are needed to halt the progression of the disease and deformity, especially to prevent and overcome paraplegia. In regards to management, every case is different and has a unique procedure. It includes simple medical management, simple decompression and debridement, anterior approach, and posterior approach, etc. Surgical decompression of the cord and instrumentation are needed in many cases besides chemotherapy. Although the anterior approach is used for cervical Pott’s disease but this procedure is very time-consuming and technically difficult in the lumbar and dorsal spine, especially in compromised patients and morbidity is more. The posterior approach alone is enough for achieving adequate decompression, debridement, reduction, fusion, reconstruction of the body, and maintaining sagittal alignment in the dorsal and lumbar Pott’s spine. The aim of the study was to describe the treatment modality and observe the outcome of treatment methods and incidence rate of infection sites among the patients of Potts spine. Material & Methods: This retrospective study was conducted at the Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Bangladesh. The study duration was 7 years, from March 2016 to January 2023. During this period, a total of 30 cases of Pott’s disease were included in the study following inclusion and exclusion criteria. Results: 53.33% had been from the youngest age group of 15-34 years, and 80 % were male. Very few participants had been female in the present study. Back pain was the primary complication for 50% of cases, while spinal infection was observed in the cervical region for 16.67% of cases, 43.33% had infections in the dorsal region, and 30 % in the lumbar region. 10.00% of the participants had been treated with non-surgical methods, with only anti-TB medication for 18 months or more. Posterior decompression was the most common treatment method, with 23.33% having only posterior decompression, and 40.00% having posterior decompression with the use of additional instruments. Conclusion: The study observed that Pott’s disease was most common among young adult males, and the most common sites of spinal infections were in the dorsal and lumbar regions in the present study population, contradictory to the general findings. Decompression treatment, with and without additional instruments, was the most common form of treatment among the present study population.
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Background: Surgical outcome in patients with cervicalspondylotic myelopathy may affects by variety of factors.Different study outcome suggest that the number of symptomsand involved levels, symptom duration and posterior approachsignificantly increased with increasing age, whereaspreoperative Japanese Orthopedic Association scoredecreased among the different age groups.Objective: The goal of this study is to analyze the surgicaloutcome by comparing younger and elderly patient groups onthe basis of preoperative radiological and clinical data.Methods: To find out the surgical outcome the clinical andradiological data of 32 patients who underwent expansivelaminoplasty were reviewed after their surgery had beenperformed. All of the Patients were divided into two groups,group (a): younger patient group (<65 yr of age; n = 13) andan elderly patient group (≥65 yr of age; n = 19). Patients wereassessed by use of the Japanese Orthopaedic Associationscale (JOA) to know the neurological status of them. Computedtomographic myelography and magnetic resonance imagingexamined for radiological feature. Finally, the effects of theclinical and radio-logical findings on neurological outcome wereinvestigated.Results: The scores of preoperative and postoperative meanof (JOA) in elderly patients were significantly lower thanyounger patients. In the elderly patients cases, the transversearea of the spinal cord at the level of maximum compressionand symptom duration were the factors that predicted anexcellent recovery on the other hand the transverse area wasthe only predictor of excellent recovery in younger patients.Intensity change on the spinal cord and age, preoperativeJapanese Orthopaedic Association score, canal diameter werenot predictive in either age range.Conclusion: Both younger and elderly patient groups thetransverse area of the spinal cord may be a reliable predictor ofexcellent recovery. In case of elderly patients shorter symptomduration was an important factor in the excellent recovery.
RESUMO
Introduction: Osteoporotic fracture is common among theelderly people. It occurs following minor trauma like slipping onthe floor or due to jolt while travelling in a vehicle on an unevenroad. It is usually associated with severe crippling local painwhich aggravates on movement, sitting or standing.Objective: Our goal in this study is to find out the outcome ofpercutaneous cement vertebroplasty & kyphoplasty forosteoporotic vertebral fracture.Methodology: This cross sectional study was carried out atDepartment of Neurosurgery, BMSSU, Dhaka from January2017 to June 2018 where 28 patients data were evaluated onthe basis of their history, clinical examination. Among thecases Per. Vertebroplasty was 23 and Balloon kyphoplastywas 5. 60% patients were female and 40% patients were male.The entered data were cross-checked and confirmed.Results: Percutaneous vertebroplasty is a minimally invasiveprocedure with very good results for the treatment of severepain due to vertebral compression fracture. It providessignificant pain relief with the potential for improving functionaloutcome.Conclusion: Percutaneous vertebroplasty and balloonkyphoplasty not only relives pain instantly but can also restorevertebral height.