Transpedicular Fixation via Posterior Approach for Dorsal and Lumbar Spine Tuberculosis

Abstract

Objective:  To determine the outcome of Transpedicular Fixation via Posterior Approach for Dorsal and Lumbar Spine Tuberculosis. Material/Methods:  This study was cross-sectional and conducted from 01/02/2015 to 30/7/2020 in the department of neurosurgery. A total of 36 patients with dorsal and lumbar spine tuberculosis were operated on for transpedicular fixation. Assessment scores were used pre-operative and post-operative and patients were kept on follow-up till six months after the surgical procedure. Variables like age, gender, spinal level, preoperative, and follow-up clinical status were calculated. Results:  There were 19 (53%) male and 17 (47%) female patients with a mean age of 27 ± 8. Thoracolumbar was the commonest segment involved in 17 (47%) patients, followed by lower thoracic in 8 (22%) and lumbar in 7 (19%). There were 7 (19%) patients on the preoperative American Spinal Injury Association (ASIA) impairment scale in grade B, 12 (33%) in grade C, 15 (42%) in grade D, and 2 (5%) in grade E. The follow-up assessment at 6 months showed that ASIA grade B was seen in 3 (8%), grade C in 4 (11%), grade D in 16 (44%), and Grade E in 13 (36%) patients. Preoperative and follow-up scores on the ASIA impairment scale, COBS ANGLE, and ESR showed a significant difference (p-value < 0.05). Conclusion:  We concluded that transpedicular fixation can restore the stability of the spine in thoracic and lumbar tuberculosis. The procedure is important for the improvement of clinical symptoms, correction of kyphosis, and stabilization of the spinal column.