Journal of Nepal Medical Association (Jul 2024)

Clinical Outcome of Posterior Instrumented Stabilization and Transpedicular Decompression in Patients Presenting with Thoracic or Lumbar Spinal Tuberculosis in a Tertiary Care Center: A Descriptive Cross-sectional Study

  • Dinesh Bhandari,
  • Sabin Pokharel,
  • Praja Pokharel,
  • Sushil Paudel,
  • Dinesh Kafle,
  • Rohit Kumar Pokharel

DOI
https://doi.org/10.31729/jnma.8718
Journal volume & issue
Vol. 62, no. 276

Abstract

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Introduction: Posterior instrumented stabilization is a commonly done surgery in spinal tuberculosis. This study aims to evaluate the clinical, radiological, and neurological outcomes of posterior instrumented stabilization and transpedicular decompression in thoracic and lumbar spinal tuberculosis. Methods: A descriptive cross-sectional study was conducted for one and a half years with at least six months of follow-up in a tertiary care center. The study was approved by the Institutional Review Committee (Reference number: 119 (6-11-5) 2/075-076). Total sampling was done and the study included patients over 18 years of age with spinal tuberculosis of the thoracic or lumbar regions. These patients underwent posterior instrumented stabilization and transpedicular decompression at the tertiary care center. The age, site of involvement, Visual Analog Scale score for back pain, neurological status as per Frankel Neurology grading, and local kyphotic angle in X-ray were recorded. The mean, standard deviation, and percentage were calculated. The data was entered in Microsoft Excel 2016 and analysis was done using Epi Info software version 7.2. Results: Thoracic level was most commonly involved in 14 (46.68%) cases. The mean back pain as assessed by the VAS score improved from 7.6 to 1.9 at the 6-month follow-up. There was improvement in the neurological grading of all cases and there was no loss of correction in the local kyphotic angle till the final follow-up. The mean age of cases was 46.10 years. Conclusions: Posterior instrumented stabilization and transpedicular decompression in adult patients with thoracic or lumbar spinal Tuberculosis achieves improvements in clinical, radiological, and neurological outcomes.

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