Extended Posterior Decompression and Instrumented Fusion for Spinal Tuberculosis

Area of Science:

• Spine surgery
• Orthopedics
• Infectious diseases

Background:

• Spinal tuberculosis (TB) treatment traditionally involves anterior debridement, which carries risks of serious complications.
• An extended posterior approach offers an alternative, potentially reducing complications associated with anterior surgery.
• This approach involves extensive removal of posterior elements, including ribs and pedicles, to address spinal TB.

Purpose of the Study:

• To evaluate the clinical and radiographic outcomes of spinal tuberculosis patients treated with extended posterior decompression, fixation, and fusion.
• To assess improvements in pain and neurologic status post-surgery.
• To analyze radiographic results across different vertebral segments.

Main Methods:

• Retrospective cohort study of 50 spinal tuberculosis patients (January 2010 - June 2016).
• Evaluation using Visual Analog Scale (VAS) for pain, Frankel grading for neurologic status, and kyphotic Cobb angle for spinal alignment.
• Comparison of pre- and postoperative clinical and radiographic data.

Main Results:

• Significant improvement in VAS scores across all treatment groups (p<0.01).
• Increased Frankel grade E from 20% preoperatively to 76% postoperatively.
• Significant reduction in kyphotic Cobb angle with minimal loss of correction at final follow-up.

Conclusions:

• Extended posterior decompression with posterior instrumentation and fusion is an effective surgical strategy for spinal tuberculosis.
• This method yields positive clinical and radiographic outcomes in the thoracic, thoracolumbar, lumbar, and lumbosacral spine.
• The posterior approach provides a viable alternative to anterior debridement for managing spinal TB.