EARLY RECOVERY AND STABILISATION WITH INSTRUMENTATION IN ANTERIOR CERVICAL SPINE TUBERCULOSIS
Abstract
Background: Tuberculous infection causes destruction, caseation, and necrosis of cervical vertebrae ormay present as an abscess. Complete recovery of neurological status is the rule after anterior surgical
decompression and fusion, even in cases with complete paraplegia or tetraplegia. Neurological
impairment and spinal deformity are the major concerns with spinal tuberculosis. Absolute nonoperative treatment was offered in pre antibiotic era. Since last decade great advances in terms of
operative options drastically changed the scenario in management of caries spine and indications for
surgery have been extended for early resolution of disease, quicker rehabilitation and prevention of late
complications. Methods: During the period from 2005 to 2012, 336 patients of spinal tuberculosis were
admitted in Department of neurosurgery, Liaquat University Hospital, Jamshoro. Forty-four patients
were considered for surgery. All 44 patients underwent decompression through anterior cervical
approach followed by fusion with iliac bone graft and then stabilization with titanium locking plate.
Results: There were 20 males and 24 females. Neck pain was the chief complaint and improved in all
cases. Patients had varying grades of motor weakness in upper and lower limbs. All the patients had
good neurological recovery after surgery. No postoperative surgical complication found in any patient.
Conclusion: Anterior cervical decompression, fusion and instrumentation with titanium plate fixation
in patients with tuberculous spondylitis gives excellent results without untoward effects.
Keywords: cervical spondylitis, Koch's spine, anterior instrumentation, cervical plating
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