The effect of time-to-surgery on outcome in patients with neurological deficits caused by spinal tuberculosis

Liu, Peng; Nie, Hai

doi:10.5137/1019-5149.jtn.18736-16.1

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…The majority of patients with ASIA B recovered to ASIA C or D postoperatively. 12,14 Other patients with ASIA C recovered to ASIA D or E in a 9-12-month period. One study was done by Choi et al, which showed neurological recovery in 63-65% of patients.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative Neurological Outcome in Spinal Tuberculosis Patients Presenting with Severe Neurological Deficits

Waqas Noor Chughtai,

Muhammad Adeel Razzaque,

Muhammad Shafiq

et al. 2023

Pak J Neurol Surg

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Objective: To determine the postoperative neurological outcome in spinal tuberculosis patients presenting with severe neurological deficits. Materials and Methods: 57 patients of 22 to 65 years of spinal tuberculosis were included in this study from January 2018 to March 2023. Data was collected from the hospital records of the patients who were admitted and operated on for tuberculosis of the spine. All regions of the spine were taken for study. ASIA scoring was done and patients were labeled from ASIA scores A to E. All patients were operated and postoperative ASIA scoring was also done on follow-up visits. An Independent sample t-test was used to assess the difference in the mean of these variables. Results: The mean age was 44.45 ± 8.54 years. Males were 39 and females 18. Preoperatively 27 patients had ASIA B, 28 patients had ASIA C and 02 patients had ASIA D score. All these patients improved postoperatively. The mean preoperative ASIA Score was 2.03 ± 2.4 and the mean postoperative ASIA score was 4.1 ± 1.3 withp-value of 0.02. Patients having old age, who present late and with poor grades in neurology had worse outcomes postoperatively. Conclusion: Patients with spinal tuberculosis presenting even with severe neurological deficits had significant improvement in neurology postoperatively. Keywords: Spinal tuberculosis (TB), American Spinal Injury Impairment Score (ASIA), Mycobacterium Tuberculosis, Potts disease, Trans-pedicular decompression and fusion, Laminectomy, Magnetic resonance imaging (MRI).

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Section: Discussionmentioning

confidence: 99%

“…These are isoniazid, rifampicin, pyrazinamide, ethambutol. 14 These are given according to body weight. Patients who fail medical management or those who develop neurological deficits, spinal deformities, or severe pain due to spinal instability need surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Neurological Outcome in Spinal Tuberculosis Patients Presenting with Severe Neurological Deficits

Waqas Noor Chughtai,

Muhammad Adeel Razzaque,

Muhammad Shafiq

et al. 2023

Pak J Neurol Surg

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“…Chemotherapy and surgery are the main treatment for spinal TB (2). The aim of the surgery is to relieve the compression of the spinal cord or nerve, reconstruct spinal stability, and correct kyphosis deformity (3,4). Radical debridement of the TB lesion is the key to spinal TB surgery (5), but the vertebral defect is often left after the debridement, thus a bone graft is of great importance to restore the height of the vertebral body and rebuild the spinal stability (6).…”

Section: Introductionmentioning

confidence: 99%

Comparison of Granular Bone Grafts and Transverse Process Bone Grafts for Single-Segmental Thoracic Tuberculosis: A Retrospective Single-Center Comparative Study

Zhu

et al. 2021

Front. Surg.

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Background: To compare the clinical efficacy of granular bone grafts and transverse process bone grafts for single-segmental thoracic tuberculosis (TB).Methods: The clinical records of 52 patients who were diagnosed with single-segmental thoracic TB and treated by one stage posterior debridement, bone graft fusion, and internal fixation in our department from 2015 to 2018 were retrospectively analyzed. Among them, 25 cases were in the granular bone graft group and 27 cases in the transverse processes bone graft group. Outcomes including the visual analog scale (VAS), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), neurological function, operative time, operative blood loss, hospital stay, Cobb angle, bone graft fusion time, and postoperative complications were all recorded and analyzed.Results: There were no significant differences in operative time, operative blood loss, and hospital stay between the two groups (P > 0.05). With an average follow-up of 18–33 months, all patients in the two groups showed significant improvement in VAS score, ESR, CRP, and neurological function compared with preoperative measurements (P < 0.05), however, no significant differences were found for the last follow-up (P > 0.05). The two groups showed similar Cobb angle correction (P > 0.05), but the granular bone graft group had a larger Cobb angle loss than the transverse processes bone graft group (P < 0.05). The bone graft fusion time of the granular bone graft group was shorter than that of the transverse processes bone graft group (P < 0.05). No significant difference was found in the postoperative complications rate between the two groups (P > 0.05).Conclusion: Granular bone grafts and transverse process bone grafts may achieve comparable clinical efficacy for single-segmental thoracic TB, but the former method had a shorter bone fusion time.

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The effect of time-to-surgery on outcome in patients with neurological deficits caused by spinal tuberculosis

Cited by 2 publications

References 10 publications

Postoperative Neurological Outcome in Spinal Tuberculosis Patients Presenting with Severe Neurological Deficits

Postoperative Neurological Outcome in Spinal Tuberculosis Patients Presenting with Severe Neurological Deficits

Comparison of Granular Bone Grafts and Transverse Process Bone Grafts for Single-Segmental Thoracic Tuberculosis: A Retrospective Single-Center Comparative Study

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