Functional and Radiological Outcomes of Anterior Decompression and Posterior Stabilization via Posterior Transpedicular Approach in Thoracic and Thoracolumbar Pott's Disease: A Retrospective Study.
10.4184/asj.2017.11.4.618
- Author:
Suryakant SINGH
1
;
Hitesh DAWAR
;
Kalidutta DAS
;
Bibhudendu MOHAPATRA
;
Somya PRASAD
Author Information
1. Department of Orthopaedics, Indian Spinal Injuries Centre, New Delhi, India. coolaryansksingh@gmail.com
- Publication Type:Original Article
- Keywords:
Thoracolumbar spine;
Pott's disease;
Transpedicular approach;
Posterior stabilization;
Anterior decompression
- MeSH:
Congenital Abnormalities;
Decompression*;
Follow-Up Studies;
Humans;
Incidence;
Retrospective Studies*;
Spinal Injuries;
Tuberculosis, Spinal*;
Visual Analog Scale
- From:Asian Spine Journal
2017;11(4):618-626
- CountryRepublic of Korea
- Language:English
-
Abstract:
STUDY DESIGN: This is a retrospective study. PURPOSE: To determine the efficacy and safety of a posterior transpedicular approach with regard to functional and radiological outcomes in people with thoracic and thoracolumbar spinal tuberculosis. OVERVIEW OF LITERATURE: Spinal tuberculosis can cause serious morbidity, including permanent neurological deficits and severe deformities. Medical treatment or a combination of medical and surgical strategies can control the disease in most patients, thereby decreasing morbidity incidence. A debate always existed regarding whether to achieve both decompression and stabilization via a combined anterior and posterior approach or a single posterior approach exists. METHODS: The study was conducted at the Indian Spinal injuries Centre and included all patients with thoracic and thoracolumbar Pott's disease who were operated via a Posterior transpedicular approach. Data regarding 60 patients were analyzed with respect to the average operation time, preoperative and postoperative, 6 months and final follow-up American Spinal Injury Association (ASIA) grading, bony fusion, implant loosening, implant failure, preoperative, postoperative, 6 months and final follow-up kyphotic angles, a loss of kyphotic correction, Oswestry disability index (ODI) score, and visual analog scale (VAS) score. Data were analyzed using either a paired t -test or a Wilcoxon Signed Rank test. RESULTS: The mean operation time was 260±30 minutes. Fifty-five patients presented with evidence of successful bony fusion within a mean period of 6±1.5 months. Preoperative dorsal and lumbar angles were significantly larger than postoperative angles, which were smaller than final follow-up angles. The mean kyphotic correction achieved was 12.11±14.8, with a mean decrease of 5.97 and 19.1 in VAS and ODI scores, respectively. CONCLUSIONS: Anterior decompression and posterior stabilization via a posterior transpedicular approach are safe and effective procedures, with less intraoperative surgical duration and significant improvements in clinical and functional status.
