A prospective study of functional outcome in Thoracolumbar potts spine with posterior only approach

Abstract

Introduction: surgical approach for thoracolumbar pott spine has been controversial. Traditionally, earlier anterior decompression and fixation had been long considered as the gold standard for treatment of tb of spine. Recently, the posterior approach has gained popularity based on the principle of adequate debridement, decompression and stable fixation with much lower complication rates, the present study aims to evaluate the results (functional, neurological, and radiological) of the posterior only approach in patients operated for thoracic and lumbar tuberculosis. Methods: all patients (n=40) who were included in the study had thoracolumbar tuberculosis of spine with or without neurological deficit and with or without deformity, were managed by only posterior decompression and fixation. Preoperative and postoperative visual analog scale, frankel neurological grading, radiologic fusion by bridwell criteria were compared and functional assessment was done by oswestry disability questionnaire. Results: Statistical significant improvement seen in Oswestry disability functional questionnaire and VAS scores (p < 0.05), the clinical outcomes were satisfactory at the end of final follow-up.no worsening of neurological deficit. Solid fusion was achieved in 85% patients after surgery. Two patient developed superficial wound infection which healed by Conservative methods and extended antibiotic therapy. Conclusion:Posterior decompression and fixation is safe and effective approach for management of patients with thoracolumbar pott spine, provides rapid relief of pain, neurological recovery by adequate decompression and prevents progression of deformity with posterior stabilization with fewer complications.