The posterior-only surgical approach in the treatment of tuberculosis of the spine: outcomes using cortical bone allografts

The Bone & Joint Journal
U N F Ukunda, M M Lukhele

Abstract

The surgical treatment of tuberculosis (TB) of the spine consists of debridement and reconstruction of the anterior column. Loss of correction is the most significant challenge. Our aim was to report the outcome of single-stage posterior surgery using bone allografts in the management of this condition. The study involved 24 patients with thoracolumbar TB who underwent single-stage posterior spinal surgery with a cortical bone allograft for anterior column reconstruction and posterior instrumentation between 2008 and 2015. A unilateral approach was used for 21 patients with active TB, and a bilateral approach with decompression and closing-opening wedge osteotomy was used for three patients with healed TB. A median of 1.25 vertebrae were removed (interquartile range (IQR) 1 to 1.75) and the median number of levels that were instrumented was five (IQR 3 to 6). The median operating time was 280 minutes (IQR 230 to 315) and the median blood loss was 700 ml (IQR 350 to 900). The median postoperative kyphosis was 8.5° (IQR 0° to 15°) with a mean correction of the kyphosis of 71.6%. Good neurological recovery occurred, with only two patients (8%) requiring assistance to walk at a mean follow-up of 24 months (9 to 50), at which time t...Continue Reading

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Citations

May 1, 2019·The Bone & Joint Journal·R N DunnM Held
May 1, 2019·The Bone & Joint Journal·M PumbergerM Putzier
Apr 7, 2020·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Changgui ZhangXiaojun Duan

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