“The improvement in kyphotic angle after Anterior Decompression and Cage Placement in tuberculosis of thoraco-lumbar spine”

ashfaq ahmed


Background; Musculoskeletal Tuberculosis is a rare form of TB comprising only 3% of all Tuberculosis patients. The commonest and most dangerous form of Tuberculosis, Spinal Tuberculosis accounts for 50% of all cases of musculoskeletal Tuberculosis.The anterior decompression with cage alone without added instrumentation with bone graft is cost effective as compared to added instrumentation in patients of third world countries
Objective; To determine the improvement in terms of mean change in postoperative kyphotic angle after anterior decompression and cage placement with bone graft in tuberculosis of Thoraco-lumbar spine.
Methods; The Quasi Experimental study was conducted in the Department of Orthopaedics and Spine of Ghurki Trust Teaching Hospital,Lahore from 1st May 2014 to 31st Apr 2016.50 patients who qualify the inclusion criteria were included. All patients underwent anterior decompression and placement of Inter body Titanium Mesh Cage with packed bone graft. Pre and Post-operative lateral view x-rays were taken to check and record the post operative change in kyphotic angle. Boston brace was applied for at least 6 months. Data was analyzed using SPSS 17.0

Results; There were 38(63.3%) males and 22(36.7%) females. The patients aged between 15-30 years were 32(53.3%),those between aged 31-45 years were 15(25%) and between 46-60 years there were 13(21.7%).There were 10 (16.6%) patients with 0-10 degree improvement, 36(60%) patients with 11-20 degree improvement and 14(23.4% ) patients with 21-30 degree improvement. Paired t-test result for change in angle is p = 0.000.
Conclusion; Anterior decompression along with Titanium mesh cage and bone graft in patients suffering from caries spine showed immediate post operative improvement in kyphotic angle.
Key Words; Caries spine, Titanium mesh cage, Anterior decompression, kyphotic angle.

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