Result of surgical decompression and internal fixation with titanium cage in patients with carries spine

ABSTRACT

The objective of the study is to assess, the postoperative outcome of the intervertebral titanium cage, in patients operated for Caries spine with unstable spine with/without neurological deficits. This is a retrospective study, carried out in department of Neurosurgery Sheikh Zayed Hospital, Rahim Yar Khan, during 2 years, from January 2006 to December 2007. All patients underwent a neurological and radiological assessment. Those patients who had collapse of vertebral body/s, with/without gibbus formation having some neurological deficit were included. Patients fit for surgery, were operated upon, with placement of intervertebral adjustable titanium cage. These patients were followed up for eighteen months. The study comprised of 11 patients, with their age ranging from 20 to 53 years having 7 males and 4 females. The patients were admitted through OPD or the emergency department in neurosurgical ward of Sheikh Zayed hospital, Rahim Yar Khan. The majority of the patients had D10-11 lesion [36.3%] followed by L2 in 18.1%. The neurological status of the patients received showed paraplegia in 27.27% while paraparesis in 72.72% of patients. The neurological outcome of 11 patients, after eighteen months of follow up, showed marked improvement in 72.72% patients of incomplete spinal cord compression [paraparesis]. While some improvement in 27.27% patients of complete spinal cord damage [paraplegia]. All patients with kyphotic lesions had near normalization of the anatomical curve of the spine. All patients were kept on antituberculous chemotherapy for one year. Our experience with usage of the titanium cage for internal fixation in Caries spine showed very promising results, especially in patients of paraperesis with/without gibbus formation. This technique may become a main stay of surgical management in Caries spine for thoracolumber region in our setup