The posterior-only surgical method within the therapy of tuberculosis of the backbone.
Bone Joint J. 2018 09;100-B(9):1208-1213
Authors: Ukunda UNF, Lukhele MM
Goals: The surgical therapy of tuberculosis (TB) of the backbone consists of debridement and reconstruction of the anterior column. Lack of correction is essentially the most vital problem. Our purpose was to report the result of single-stage posterior surgical procedure utilizing bone allografts within the administration of this situation.
Sufferers and Strategies: The research concerned 24 sufferers with thoracolumbar TB who underwent single-stage posterior spinal surgical procedure with a cortical bone allograft for anterior column reconstruction and posterior instrumentation between 2008 and 2015. A unilateral method was used for 21 sufferers with lively TB, and a bilateral method with decompression and closing-opening wedge osteotomy was used for 3 sufferers with healed TB.
Outcomes: A median of 1.25 vertebrae have been eliminated (interquartile vary (IQR) 1 to 1.75) and the median variety of ranges that have been instrumented was 5 (IQR three to six). The median working time was 280 minutes (IQR 230 to 315) and the median blood loss was 700 ml (IQR 350 to 900). The median postoperative kyphosis was eight.5° (IQR zero° to 15°) with a imply correction of the kyphosis of 71.6%. Good neurological restoration occurred, with solely two sufferers (eight%) requiring help to stroll at a imply follow-up of 24 months (9 to 50), at which period there was a imply enchancment in incapacity, as assessed by the Oswestry Incapacity Index, of 83% (90% to 72%).
Conclusion: The posterior-only method utilizing cortical allografts for anterior column reconstruction achieved good medical and radiological outcomes. Differentiation ought to be made between versatile (lively) and inflexible (healed) TB backbone. Cite this text: Bone Joint J 2018;100-B:1208-13.
PMID: 30168757 [PubMed – indexed for MEDLINE]