The Improvement in Kyphotic Angle after Anterior Decompression and Cage Placement in Tuberculosis of Thoraco-lumbar Spine

  • Ashfaq Ahmed Resident Orthopaedic Surgery) Ghurki Trust Teaching Hospital,
  • ASHFAQ AHMED Department of Orthopaedic Surgery, Ghurki Trust Teaching Hospital
  • SAEED AHMAD Department of Orthopaedic Surgery, Ghurki Trust Teaching Hospital
  • Rizwan Akram Department of Orthopaedic Surgery, Ghurki Trust Teaching Hospital
  • Shahzad Javed Department of Orthopaedic Surgery, Ghurki Trust Teaching Hospital
Keywords: Caries spine, Titanium mesh cage, Anterior decompression, kyphotic angle

Abstract

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.
Materials and 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 2016.60 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, Post-operative and follow-up lateral view x-rays were taken to check and record the post operative change in kyphotic angle as well as loss in follow up. All the patients were followed for at least 1 year. 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 improve-ment and 14 (23.4%) patients with 21 – 30 degree improvement. Paired t-test result for change in angle is p = 0.000 which is statistically significant.
Conclusion: Anterior decompression with Standalone Titanium mesh cage and bone graft in patients suffering from caries spine showed immediate post operative improvement in kyphotic angle as well as no significant loss in correction in follow-up.

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Published
2018-10-04
Section
Original Articles