Thoracic and lumbar spine Pott's spine surgery results five institutional a multicenter study compares transpedicular decompression with and without general reconstructive surgery
Keywords:
Tuberculosis of the spine, surgical decompression, artificial implantsAbstract
Objectives: The purpose of this study was to compare the radiological and clinical results of transpedicular decompression in spinal TB (also known as Pott's spine) patients who had anterior reconstruction using a polyetheretherketone (PEEK) or mesh cage with those who did not. Little study has been conducted on the long-term effects of transpedicular decompression with and without global reconstruction in Pott's spine. PEEK cages for Pott's spine have also not been shown effective. Methods: This Multicenter study was conducted in the department of neurosurgery MMC Mardan between May 2019 and May 2022. Patients who had surgery for Pott's spine and satisfied the inclusion criteria were retrospectively examined using data from hospital records and an imaging database collected. Results: One hundred and fifteen patients were involved in the research, and their mean age was 45.0617.01 years (55 males, 60 females). These individuals showed improvements on the Visual Analog Scale, the Oswestry Disability Index, and the Cobb angle, all statistically significant improvements (p 0.002). The Cobb angle was corrected more in patients who received anterior reconstruction after surgery (p = 0.041), but they also experienced more blood loss (p = 0.03).
Downloads
References
Rajasekaran S, Soundararajan DC, Shetty AP, Kanna RM. Spinal tuberculosis: current concepts. Global Spine J 2018;8(4 Suppl):96S-108S.
World Health Organization. Global tuberculosis report: executive summary [Internet]. Geneva: World Health Organization; 2019 [cited 2020 Sep 19]. Available from: https://www.who.int/tb/publications/global_report/ GraphicExecutiveSummary.pdf.
Tuli SM. Severe kyphotic deformity in tuberculosis of the spine. Int Orthop 1995;19:327-31.
Jain A, Jain RK, Kiyawat V. Evaluation of the outcome of transpedicular decompression and instrumented fusion in thoracic and thoracolumbar tuberculosis. Asian Spine J 2017;11:31-6.
Benli IT, Kaya A, Acaroglu E. Anterior instrumen- tation in tuberculous spondylitis: is it effective and safe? Clin Orthop Relat Res 2007;460:108-16.
Chen WJ, Wu CC, Jung CH, Chen LH, Niu CC, Lai PL. We combined anterior and posterior surgeries in the treatment of spinal tuberculous spondylitis. Clin Or- Orthop Relat Res 2002;(398):50-9.
Lee SH, Sung JK, Park YM. Single-stage transpedicular- lar decompression and posterior instrumentation in treating thoracic and thoracolumbar spinal tuberculosis: a retrospective case series. J Spinal Disord Tech 2006;19:595-602.
Ha KY, Chung YG, Ryoo SJ. Adherence and biofilm formation of Staphylococcus epidermidis and Mycobacterium tuberculosis on various spinal implants. Spine (Phila Pa 1976) 2005;30:38-43.
Fayazi AH, Ludwig SC, Dabbah M, Bryan Butler R, Gelb DE. Preliminary results of staged anterior de- bridement and reconstruction using titanium mesh cages in treating thoracolumbar vertebral osteomyelitis. Spine J 2004;4:388-95.
Tschöke SK, Fuchs H, Schmidt O, Gulow J, von der Hoeh NH, Heyde CE. Single-stage debridement and spinal fusion using PEEK cages through a posterior approach to eradicate lumbar pyogenic spondylodiscitis: a safe treatment strategy for a dangerous condition. Patient Saf Surg 2015;9:35.
Li Z, Wu W, Chen R, Huang Y, Chen X, Lin J. Could Allograft bones combined with poly-ether-ether-ketone cages or titanium mesh cages be an alternative grafting method in the management of cervical spinal tuberculosis? World Neurosurg 2019;128:e653-9.
Tuli SM. Results of treatment of spinal tuberculosis by "middle-path" regime. J Bone Joint Surg Br 1975;57:13-23.
Tuli SM. Historical aspects of Pott’s disease (spinal tuberculosis) management. Eur Spine J 2013;22 Suppl 4(Suppl 4):529-38.
Khanna K, Sabharwal S. Spinal tuberculosis: a comprehensive review for the modern spine surgeon. Spine J 2019;19:1858-70.
Zhang H, Sheng B, Tang M, et al. One-stage surgical treatment for upper thoracic spinal tuberculosis by internal fixation, debridement, and combined interbody and posterior fusion via posterior-only approach. Eur Spine J 2013;22:616-23.
D'souza AR, Mohapatra B, Bansal ML, Das K. Role of posterior stabilization and transpedicular decompression in treating thoracic and thoracic-lumbar TB: a retrospective evaluation. Clin Spine Surg 2017;30:E1426-33.
Liu Z, Zhang P, Zeng H, Xu Z, Wang X. A comparative study of single-stage transpedicular debridement, fusion, and posterior long-segment versus short-segment fixation for the treatment of thoracolumbar spinal tuberculosis in adults: minimum five-year follow-up outcomes. Int Orthop 2018;42:1883-90.
Waliullah S, Kumar V, Rastogi D, Srivastava RN. If- efficacy of transpedicular decompression in spinal tu- tuberculosis. Orthop Proc 2019;101-B(SUPP_3):13.
Robinson Y, Tschoeke SK, Kayser R, Boehm H, Hey- de CE. Reconstruction of large defects in vertebral osteomyelitis with expandable titanium cages. Int Orthop 2009;33:745-9.
Christodoulou AG, Givissis P, Karataglis D, Symeoni- this PD, Pournaras J. Treatment of tuberculous spon- dactylitis with anterior stabilization and titanium cage. Clin Orthop Relat Res 2006;444:60-5.
Published
How to Cite
Issue
Section
Copyright (c) 2023 International journal of health sciences
![Creative Commons License](http://i.creativecommons.org/l/by-nc-nd/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.