5 research outputs found
Original Article - Anterior instrumentation for cervical spine tuberculosis: An analysis of surgical experience with 61 cases
OBJECTIVE: To evaluate the efficacy of anterior instrumentation in
patients with subaxial and cervicodorsal spinal tuberculosis in
reconstruction of the spine, providing pain relief, neurological
recovery and prevention of deformity. MATERIALS AND METHODS: The
records of 61 consecutive patients, of surgically treated spinal
tuberculosis affecting C3 to D2 region, in our neuro and spinal surgery
unit over a five-year period were retrospectively reviewed. Patients
with involvement of the C3-C6 vertebrae underwent excision of the
involved vertebrae and intervertebral discs followed by reconstruction
with titanium implants by anterior approach. A transclavicular approach
was used for patients with involvement of the C7-D2 vertebrae. A
five-drug antituberculous regimen was administered for a period of one
year. The follow-up ranged from 24 to 84 months (mean 38 months).
Clinical and radiological assessment using flexion and extension
radiographs was performed at 24 months for all cases. RESULTS: The
neck pain score based on a visual analog scale (1-10) changed from a
pre-operative average of 7 to 2 at follow-up after 4 months. Fifty-two
patients (85%) had complete relief of pain while 16 patients who had
Grade III to IV muscle strength regained complete power. The asymmetric
wasting in patients with involvement of the cervicodorsal region did
not recover completely. Flexion-extension radiographs at 24 months did
not show any evidence of instability or nonunion. CONCLUSIONS:
Anterior reconstruction using titanium plates and locking screws for
stabilization of the subaxial and cervicodorsal region tuberculosis is
a useful adjunct in preventing kyphotic deformity. A satisfactory
segmental stability and fusion is achieved by this technique