Role of anterior decompression with internal fixation in dorsal spine tuberculosis

ABSTRACT

To assess efficacy of anterior decompression and internal fixation using mesh cage and rod with screws in patients with dorsal spine tuberculosis This observational study was conducted in the Department of Neurosurgery Lady Reading Hospital Peshawar from July 2010 to June 2012 [2 years]. There were 38 patients with dorsal spine tuberculosis who underwent anterior decompression and fusion using anterior spinal instrumentation and allograft replacement. We included those patients in our study, who undergone anterior decompression with internal fixation for dorsal spine tuberculosis, of both genders irrespective of their age. We excluded those patients who were unfit for surgery, treated conservatively, involved spine other than dorsal spine or undergone procedure other than anterior approach for Carrie's spine. Clinical outcome of the patients was assessed using the frankle grade. The patients were observed for post-operative complications, neurological improvement and bony fusion. We had total of 38 patients who undergone the procedure in whom23 [60.5%] were males and 15 [39.5%] females with male / female ratio of 1.5 1. Their age ranged from 4-70 years [mean 37years]. The most common level involved were between D5-D12 for which thoracotomy was needed. Preoperative neurodeficit was observed in 76.3% patients of whom 89.7% showed improvement after surgery. Our patients had 7.9% complications after surgery. We had wound infection in 5.3% and dyspnea in 2.6% cases. There were no graft related complications and bony fusion was observed in all the patients. It is concluded from our study that anterior decompression with internal fixation using cage and rod with screws is an effective procedure in dorsal spine tuberculosis. It has few complications and yields good results: