Asian Spine Journal (Apr 2022)

Surgical Outcomes of Transpedicular Decompression with or without Global Reconstruction in Thoracic/Thoracolumbar Pott’s Spine: A 7-Year Institutional Retrospective Study

  • Kalyan Kumar Varma Kalidindi,
  • Kuldeep Bansal,
  • Gourab Biswas,
  • Anuj Gupta,
  • Gayatri Vishwakarma,
  • Vikas Tandon,
  • Harvinder Singh Chhabra

DOI
https://doi.org/10.31616/asj.2021.0008
Journal volume & issue
Vol. 16, no. 2
pp. 173 – 182

Abstract

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Study Design Retrospective case-control study. Purpose This study aimed to analyze the radiological and clinical outcomes of transpedicular decompression in spinal tuberculosis (or Pott’s spine) with and without anterior reconstruction using polyetheretherketone (PEEK) or mesh cage. Overview of Literature The outcomes of transpedicular decompression with and without global reconstruction in Pott’s spine are insufficiently investigated. Additionally, the use of PEEK cages in Pott’s spine has remained unestablished. Methods Using the hospital records and imaging database obtained from January 2014 to January 2020, this study retrospectively analyzed patients who underwent surgery for Pott’s spine and met the eligibility criteria. Results This study included 230 patients with a mean±standard deviation age of 47.7±18.1 years (109 males, 121 females). The Visual Analog Scale score, Oswestry Disability Index, and Cobb angle were significantly improved in these patients (p<0.001). Patients who underwent anterior reconstruction had a greater correction in Cobb angle postoperatively (p=0.042) but also had a greater blood loss (p=0.04). During the follow-up, they experienced a significant loss of correction compared with those who only underwent transpedicular decompression (p=0.026). Nevertheless, patients who underwent anterior reconstruction using mesh/PEEK cages showed no significance difference in the clinical or radiological outcomes. Conclusions Transpedicular decompression used in the surgical management of Pott’s spine showed favorable clinical and radiological outcomes. The additional use of anterior reconstruction obtained equivalent clinical outcomes but resulted in excessive blood loss. Meanwhile, the use of mesh/PEEK cage for anterior reconstruction did not affect the clinical and radiological outcomes.

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