Surgical Outcome of Spinal Tuberculosis Regarding Pain, Neurological Deficit, and Spinal Instability

Abstract

Objective:  The most prevalent type of skeletal TB, which accounts for nearly half of all cases, affects the spinal column. Regarding pain, neurological deficit, and spinal instability, the study sought to determine the surgical outcome of spinal tuberculosis. Material and Methods:  This study was conducted in the Department of Neurosurgery, Ayub Teaching Hospital. A total of 42 patients with ages ranging from 24 – 66 years were included in the study. Information about the patient was gathered to determine indications (neurological impairments) about the ASIA Grading Scale and frequently affected areas. Results:  Commonest location was a thoracolumbar junction in 42.8%, followed by the lumbar spine in 23.8%. The pain was found in all subjects. The main indication of surgery was neurological deficit which is seen in 57% of patients followed by spinal instability or deformity in 16.6% of patients and patients with failed chemotherapy in 4.7% of patients. The preoperative KA was between 30 – 60º with a mean of 43.06 ± 4.11 degrees and 9.45 ± 3.99 degrees for postoperative KA (p-value < 0.0001). Most fixations of the cord were done through a posterior approach that was in 83.3% of patients. The neurological improvement according to ASIA grading was seen in 95.2% and no improvement was seen in 4.7% of patients upon 3 months follow-up. Conclusion:  Surgical treatment of the caries spine improves pain, lowers neurological compression, and successfully reverses deformities like kyphosis, resulting in better clinical results. It also helps to remove the Tuberculous burden from the body.