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Thoracic Tuberculous Spondylitis: Posterior Approach Single-Stage Stabilization, Debridement, and Local Grafting

Article

Last updated: 27 Dec 2024

Subjects

-

Tags

Orthopedic Surgery.

Abstract

Background: Different approaches are employed to treat patients with Pott's disease who are candidates for surgical intervention. Each of these approaches has advantages and disadvantages.
Objectives: This retrospective study presents the surgical, clinical, and radiological outcomes of posterior alone single-stage debridement and grafting of single-level tuberculous discitis using local graft from the decompression and nearby spinous processes.
Patients and Methods: Between 2012 to June 2016, 15 patients with thoracic tuberculous spondylitis were operated up through posterior approach starting with one side fixation thorough debridement of the lesion and the use of local graft form decompression and spinous process bone. Clinical evaluation was done using Visual Analogue Scale (VAS) for back pain, Oswestry Disability Index (ODI), and Frankel Grade classification. Radiological assessment of kyphotic angle and fusion was also performed.
Results: The mean operative time was 115.3 ± 23.6 minutes. The mean amount of blood loss was 571.3 ± 142.4 ml. Hospital stay ranged from 3 to 7 days (mean 4 ± 0.6 days). Patients were followed for 30.27 ± 6.5 months. All patients showed significant improvement in clinical and radiological parameters. Twelve patients showed neurological improvement. One patient required reoperation for neurological deterioration. Radiological follow-up showed solid fusion within 6 months postoperatively.
Conclusion: Single-stage debridement of thoracic Pott's lesion with the use of transpedicular fixation and local graft under perioperative coverage of antitubercular chemotherapy yielded satisfactory results avoiding the need for the more morbid and technically demanding anterior procedures and the graft donor site morbidity.

DOI

10.21608/svuijm.2021.74809.1175

Keywords

Pott's disease, Tuberculous Spondylitis, Posterior surgery, Local graft

Authors

First Name

Hamdy

Last Name

Tammam

MiddleName

-

Affiliation

Department of Orthopaedic Surgery, Faculty of Medicine, South Valley University, Qena, Egypt

Email

rhtammam79@gmail.com

City

Qena

Orcid

-

First Name

Elsayed

Last Name

Said

MiddleName

-

Affiliation

Department of Orthopaedic Surgery, Faculty of Medicine, South Valley University, Qena, Egypt

Email

elsayed71@yahoo.com

City

Qena

Orcid

0000-0001-8299-9038

Volume

4

Article Issue

2

Related Issue

26313

Issue Date

2021-08-01

Receive Date

2021-05-01

Publish Date

2021-08-01

Page Start

45

Page End

68

Print ISSN

2735-427X

Online ISSN

2636-3402

Link

https://svuijm.journals.ekb.eg/article_169101.html

Detail API

https://svuijm.journals.ekb.eg/service?article_code=169101

Order

6

Type

Original research articles

Type Code

1,520

Publication Type

Journal

Publication Title

SVU-International Journal of Medical Sciences

Publication Link

https://svuijm.journals.ekb.eg/

MainTitle

Thoracic Tuberculous Spondylitis: Posterior Approach Single-Stage Stabilization, Debridement, and Local Grafting

Details

Type

Article

Created At

23 Jan 2023