Outcome of Titanium Mesh Cage and Dynamic Compression Plate (D.C.P) in Anterior Spinal Fixation in Dorsolumbar Tuberculosis
Keywords:
Tuberculosis,, Anterior Approach, Titanium Mesh Cage, Dynamic Compression Plates.Abstract
Tuberculosis is endemic in Pakistan and mostly spine is affected in extra-pulmonary cases. Anti TB chemotherapy remains the standard conservative treatment. Surgery is performed in cases with failure of medical therapy, significant spinal deformity and/or compression of neural element. As TB spine mostly affects anterior elements of the spine, debridement and fusion by an anterior approach is the procedure of choice.
Material and Methods: We included 60 patients in our study in age range of 15 — 60 years with no sex predilection from September 2012 to October 2014. Debridement of the involved spinal segments and recon-struction of the damaged vertebral bodies by using Titanium mesh cage fixed with D-C Plates and screws was done and outcome assessed at 3 months both neurologically and radio logically.
Results: In our study, mean age of the patients was 31.7 years. 63.3% were males and 36.7% were females. Pre-Operatively, most of the patients were in Frankel Grade C (41.7%). At 3 months follow-up, 76.7% of the patients improved neurologically. Radio-logical evidence of fusion was found in 85% of patients.
Conclusion: Titanium Mesh Cage filled with bone pieces and fixed by DCP and screws to reconstruct the tuberculous spine via an anterior approach along with ATT leads to the fusion of spine, maintaining height and stability in majority of the cases.
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