Does Mesh Cage Subsidence Have any Effect on Functional Outcome in Spinal Tuberculosis?

Area of Science:

• Spine surgery
• Orthopedic oncology
• Radiology

Background:

• Spinal tuberculosis often leads to poor bone quality, increasing the risk of mesh cage subsidence after anterior column reconstruction.
• Mesh cage subsidence is a frequent radiological finding in these patients.

Purpose of the Study:

• To determine the effect of mesh cage subsidence on functional outcomes in patients with spinal tuberculosis undergoing anterior column reconstruction.
• To evaluate the relationship between subsidence severity and clinical outcomes.

Main Methods:

• A retrospective review of 30 patients (age 4-60) with dorsolumbar tuberculosis who underwent anterior column reconstruction via a posterior-only approach.
• Clinical outcomes were assessed using the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and ASIA scale.
• Radiological evaluation included interbody height loss (subsidence), fusion, and segmental angle, with follow-up at regular intervals.

Main Results:

• Clinical parameters such as VAS and ODI showed significant improvement postoperatively, which was maintained even after subsidence (P < 0.05).
• No significant difference in ODI or VAS scores was observed across different categories of subsidence severity (P = 0.961 and P = 0.975, respectively).
• Subsidence was found to be non-specific regarding patient age and spinal level involved.

Conclusions:

• Mesh cage subsidence, despite occurring with varying severity due to weakened vertebral bodies in spinal tuberculosis, does not significantly impact functional outcomes.
• The study suggests that subsidence does not negatively affect pain, disability, or radiological fusion in this patient population.