Functional Outcome after Anterior Decompression and Stabilization using Locally Made Stand-alone Titanium Cage with Bone Graft in Caries Spine: An Experience of 600+ Cases at Ghurki Hospital. Issue 1 (April 2016)

• Record Type: Journal Article
• Authors: Khan, Ahsan Akhtar; Aziz, Amer
• Is Part Of: Global spine journal. Volume 6:Issue 1(2016)Supplement
• Page Start: s-0036-1582672
• Page End: s-0036-1582672
• Publication Date: 2016-04
• Subjects: Spine -- Diseases -- Periodicals; Spine -- Diseases -- Treatment -- Periodicals; Spine -- Abnormalities -- Periodicals; Spine -- Surgery -- Periodicals; 616.73
• DOI: 10.1055/s-0036-1582672
• Languages: English
• ISSNs: 2192-5682

Abstract

Introduction: Tuberculosis is the leading cause of death in third world countries, from a single infectious disease. It paralyses the society when it affects the spine due to its residual neurological deficit in the form of Quadriplegia, paraplegia, loss of bladder and bowel control, bedsores, as well as from continuous financial burden it exerts on the affected family and whole society. Early spinal decompression and stabilization with a locally made stand alone cage have dramatic results in terms of improvement in neurology, relief of pain and correction of deformity as well as improvement in the patient's quality of life. Methods: The objective of the study is to determine the outcome after Anterior Decompression and Stabilization with locally made stand alone Cage & Bone Graft in caries spine in terms of improvement of neurology, relief of pain, improvement of Kyphotic angle as well as quality of life improvement. It is a prospective case series study including 600 cases, which were treated at GTTH from 2005–15. After pre-operative assessment of pain, neurology, measurement of angle of deformity, and QOL analysis using the SF-36®, all patients were treated with Ant. Decompression and then stabilization was achieved using morcellized bone graft with a locally made stand alone cage. After surgery patients were followed at 06 weeks, 03 months, 06 months & 01 year to assess neurology, relief of pain and Kyphotic angle and their SF-36® scores. Results: Neurology improved in 88% of patients, pain was relieved in 92% of cases and there was mean correction of 18° in Kyphotic angle at the end of 01 year follow up with a significant improvement in the patient's quality of life. Conclusion: Early diagnosis and early intervention gives excellent results in Tuberculosis of the spine. After anterior decompression, stabilization with cage and bone graft results in significant improvement of neurology, relief of pain and correction of Kyphotic deformity, as well as the patient's quality of life. There is no need for added instrumentation.