Abstract :
The selection of anterior versus posterior approach for surgical treatment of thoracic or lumbar tuberculosis is still a matter of debate. The extra pleural anterolateral approach which has less morbidity compared with two stage approach provides simultaneous exposure of both anterior and posterior parts of the spine and allows anterior decompression of the spinal cord along with posterior stabilisation and anterior and posterior fusion in one stage through a single approach.
Materials and Methods: The study included45 patients with TB spine who have undergone modified extended lateral decompression and posterior instrumentation between Jan 2016 to Jan 2020. Qualitative evaluation was done with help of ODI scoring for the entire patient. Radiologically all patients were evaluated for the fusion and correction of kyphosis post operatively and progression of kyphosis over period of 2 years.
Results: The average preoperative ODI score was 21.47 (range 12 to 34 and standard deviation of 6.868) and 4.44 post operatively (range 0 to 14 and standard deviation of 3.042). The average value of preoperative angle of kyphosis was 25.73º (range 11-51º). The average values of angles at immediate postoperative, at 6 months postoperative, one year post-operative and at the end of two years post operative were 9.76º (range 2º to 26º), 11.58º (range3º to 28º), 12.51 (range 4 to 31)and 12.58º(range 4º to 30º) respectively.
Conclusion: Decompression of spine tuberculosis through extended Lateral approach using bone graft for fusion along with posterior instrumentation as a single stage procedure is an ideal procedure to treat spinal tuberculosis which requires surgical management.
Keyword :
Decomoression of spine, Tuberculosis spine, Extended lateral approach spine, Extra pleural approach of spine, Anterior and posterior spinal fusion.