A STUDY ON OUTCOMES AND COMPLICATIONS OF INSTRUMENTATION IN SPINAL TUBERCULOSIS

Dr. Robert Ahmed Khan*, Dr. Md. Moshiur Rahman and Dr. Abu Saleh Md. Abu Obaida

ABSTRACT

Introduction: Spinal tuberculosis (TB) is one of the earliest diseases known to have infected the human race. It may cause neurological deficit and spinal deformity. Spinal instrumentation stabilizes the spine and restores mechanical balance. Objective: The main objective of this is to assess the outcomes and complications of instrumentation in spinal tuberculosis. Method: In this retrospective study, a total of 40 patients were observed, of which 28 were male and 12 were female. This study investigated data on all cases of spinal tuberculosis in a private hospital (Comfort Hospital), Dhaka, Bangladesh from 2016 to 2019 which provided combined posterior instrumentation and anterior spinal fusion. This study included in all cases of instability, kyphotic deformity or loss of lordosis. Clinical outcomes were assessed on a follow-up to one year using the Visual Analog Scale (VAS), updated MacNab Parameters and radiographic outcomes (segmental kyphotic angle). Patients were evaluated for kyphotic correction, fusion formation and neurological status before and after the surgery. Results: 12 cervical and cervicothoracic lesions, 10 thoracic and thoracolumbar lesions and 18 lumbar and lumbosacral lesions, were found. 13 patients had mainly anterior surgery, 16 had posterior surgery and 11 patients had combined instrumentation surgery. The mean VAS scores showed a decrease and radiographies showed improved kyphotic angles. Using the updated MacNab criteria, 14 cases had an outstanding performance, 19 good, 5 average and 2 bad. Conclusion: Instrumentation helps to achieve not only stabilization of the spine but also deformity correction. Stabilization followed by early mobilization enable continuous healing. Depending on the situation the option of implant should be individualized. If clinical procedures are followed, the operating complications and residual deficits can be reduced in spinal tuberculosis surgery.

Keywords: Instrumentation, Tuberculosis, Neurological deficit, Spinal deformity.