Evaluation of Therapeutic Efficacy of Surgical Intervention in Dorsal Spinal Tuberculosis
Therapeutic Efficacy of Surgical Intervention in Dorsal Spinal Tuberculosis
DOI:
https://doi.org/10.54393/pjhs.v3i04.159Keywords:
Tuberculosis, Mycobacterium and ParaparesisAbstract
Tuberculosis (TB) is an infectious disease. The mycobacterium tuberculosis is the causative agent of TB. The prevalence of TB is influenced by the economic, sanitary, and medical conditions of the area. Although TB has the worldwide prevalence but it is most common in underdeveloped and developing nations like Pakistan, China, and several African nation. The every 24 to 32 people out of 100,000 in developed countries are suffering from TB. Objective: To analyze the surgical intervention for active dorsal spinal tuberculosis at early stage in patients suffering from paraparesis and paraplegia. Methods: This retrospective study was conducted at the neurosurgery department of the tertiary care hospital for the duration of four years and six months from January 2017 to June 2021. The study was carried out on 138 patients. There were 85 male and 53 female candidates. Written consent was taken from the patients. In order to determine the therapeutic effects of surgery, the neurological status on ASIA grading and NASCIS scores were examined. Results: Majority of the patients healed after single posterior procedure. The average time of surgery was 193 minutes approximately, and the mean blood loss was found to be 874 ml. The average motor improvement in NASCIS score for paraplegia was 78±13.1 and for paraparesis; it was 100 ± 0.0. Conclusions: In this study, it was concluded that early surgical intervention can prove to be beneficial in case of active dorsal spinal TB patients with cord compression.
References
Li W, Liu Z, Xiao X, Xu Z, Sun Z, Zhang Z, et al. Early surgical intervention for active thoracic spinal tuberculosis patients with paraparesis and paraplegia. BMC Musculoskeletal Disorders. 2021 Feb; 22(1):213. doi: 10.1186/s12891-021-04078-y
Hristea A, Constantinescu RV, Exergian F, Arama V, Besleaga M, Tanasescu R. Paraplegia due to non-osseous spinal tuberculosis: report of three cases and review of the literature. International Journal of Infectious Diseases. 2008 Jul; 12(4):425-9. doi: 10.1016/j.ijid.2007.12.004
Batirel A, Erdem H, Sengoz G, Pehlivanoglu F, Ramosaco E, Gülsün S, et al. The course of spinal tuberculosis (Pott disease): results of the multinational, multicentre Backbone-2 study. Clinical Microbiology and Infection. 2015 Nov; 21(11):1008.e9-1008.e18. doi: 10.1016/j.cmi.2015.07.013
Agrawal V, Patgaonkar PR, Nagariya SP. Tuberculosis of spine. Journal of craniovertebral junction and spine. 2010 Jul; 1(2):74. doi: 10.4103%2F0974-8237.77671
Hernández-Albújar S, Arribas JR, Royo A, González-García JJ, Peña JM, Vázquez JJ. Tuberculous radiculomyelitis complicating tuberculous meningitis: case report and review. Clinical Infectious Diseases. 2000 Jun; 30(6):915-21. doi: 10.1086/313821
Fan J, Lan T, Tang K, Wang G, Dong W, Li D, et al. The Comparative Influence of 2 and 4 Weeks Preoperative Antituberculosis Treatment on Spinal Tuberculosis Surgery: A Multicenter, Prospective, Randomized Clinical Trial. Infectious Disease and Therapy. 2021 Sep; 10(3):1451-1463. doi: 10.1007/s40121-021-00462-2
Jain AK and Kumar J. Tuberculosis of spine: neurological deficit. European Spine Journal. 2013 Jun; 22 Suppl 4(Suppl 4):624-33. doi: 10.1007/s00586-012-2335-7
Gautam MP, Karki P, Rijal S, Singh R. Pott's spine and paraplegia. Journal of Nepal Medical Association. 2005 Sep; 44(159):106-15
Pattisson PR. Pott's paraplegia: an account of the treatment of 89 consecutive patients. Paraplegia. 1986 Apr; 24(2):77-91. doi: 10.1038/sc.1986.11
Jain AK, Dhammi IK, Prashad B, Sinha S, Mishra P. Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach. Journal of Bone and Joint Surgery. 2008 Nov; 90(11):1477-81. doi: 10.1302/0301-620X.90B11.20972
Khoo LT, Mikawa K, Fessler RG. A surgical revisitation of Pott distemper of the spine. The Spine Journal. 2003 Apr; 3(2):130-45. doi: 10.1016/s1529-9430(02)00410-2
Kumar R. Spinal tuberculosis: with reference to the children of northern India. Childs Nervous System. 2005 Jan; 21(1):19-26. doi: 10.1007/s00381-004-1029-9
Khanna K and Sabharwal S. Spinal tuberculosis: a comprehensive review for the modern spine surgeon. Spine Journal. 2019 Nov; 19(11):1858-1870. doi: 10.1016/j.spinee.2019.05.002
Ansari S, Amanullah MF, Ahmad K, Rauniyar RK. Pott's Spine: Diagnostic Imaging Modalities and Technology Advancements. North American Journal of Medicine and Science. 2013 Jul; 5(7):404-11. doi: 10.4103/1947-2714.115775.
Ukunda UNF and Lukhele MM. The posterior-only surgical approach in the treatment of tuberculosis of the spine: outcomes using cortical bone allografts. The Bone and Joint Journal. 2018 Sep; 100-B(9):1208-1213. doi: 10.1302/0301-620X.100B9.BJJ-2017-1326.R2
Cottle L and Riordan T. Infectious spondylodiscitis. Journal of Infectiion. 2008 Jun; 56(6):401-12. doi: 10.1016/j.jinf.2008.02.005
Kaul R, Chhabra HS, Kanagaraju V, Mahajan R, Tandon V, Nanda A, et al. Antepartum surgical management of Pott's paraplegia along with maintenance of pregnancy during second trimester. European Spine Journal. 2016 Apr; 25(4):1064-9. doi: 10.1007/s00586-015-4045-4
Thwaites G, Fisher M, Hemingway C, Scott G, Solomon T, Innes J, et al. British Infection Society guidelines for the diagnosis and treatment of tuberculosis of the central nervous system in adults and children. Journal of Infection. 2009 Sep; 59(3):167-87. doi: 10.1016/j.jinf.2009.06.011
Luk KD. Tuberculosis of the spine in the new millennium. European Spine Journal. 1999; 8(5):338-45. doi: 10.1007/s005860050185
Kotil K, Alan MS, Bilge T. Medical management of Pott disease in the thoracic and lumbar spine: a prospective clinical study. Journal of Neurosurgery: Spine. 2007 Mar; 6(3):222-8. doi: 10.3171/spi.2007.6.3.222
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments