Neurological Outcomes and Correction of the Kyphosis Cobb Angle Following Single Posterior Debridement, Posterolateral Fusion, and Instrumentation for Thoracic and Lumbar Spinal Tuberculosis
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Abstract
Background: The incidence of tuberculosis (TB) is increasing in developing countries. Spinal TB is the most common skeletal tuberculosis, accounting for approximately 50% of all skeletal tuberculosis cases. Antituberculosis drugs are a crucial role in spinal TB treatment. The optimal surgical treatment for spinal TB remains controversial. In recent years, Posterior surgery alone has been proven to result in good neurological outcomes, better correction of kyphosis, and fewer surgical complications.
Methods: A retrospective descriptive study of 24 patients diagnosed with thoracolumbar spinal tuberculosis. The study examined the neurological outcomes (ASIA score) and correction of kyphosis Cobb angle based on pre-operative X-rays, post-operative, and 1-year follow-up after receiving treatment operation procedure includes single posterior debridement, posterolateral fusion, and instrumentation with pedicle screws in Sisaket Hospital from January 2017 to December 2022.
Result: The mean age, surgery time, blood loss, hospitalization time, were 57.3±13.8 years, 116.7±43.3 min, 460.4±314.2 ml, 15.3±8.1 days, respectively. The mean angle of pre-operative X-rays, post-operative, and 1-year follow-up were 16.8 ± 7.5, 9.5 ± 6.9, and 11.8 ± 7.5 degrees, respectively. The correction of kyphosis post-operative compared to pre-operative reached up to 43%, showing statistically significant differences in the angle correction (p < 0.05). Neurological outcomes based on the ASIA score pre-operative and 1-year follow-up demonstrated statistically significant neurological recovery (p < 0.05).
Summary: The surgical procedure of posterior debridement, posterolateral fusion, and instrumentation in patients with thoracolumbar spinal tuberculosis, has proven to be a safe surgical intervention. It has displayed favorable neurological recovery outcomes and effective correction of kyphosis (Cobb angle).
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