ABSTRACT

Purpose:

There is consensus on medical management of tuberculous spondylitis (TBS); however, literature is quite divided on surgical management of TBS. We aimed to illustrate surgical indications and treatment modalities for TBS in the management of selected patients.

Materials and Methods:

A total of 19 patients with different vertebral tuberculosis were treated with surgical intervention. There were 10 male and 9 female patients, mean age was 48±18.1 years and mean follow-up time was 59.9±27.7 months. There was avarage 1.2±0.5 disc and 2.2±0.5 vertebral body involvement.

Results:

15 cases were surgically debrided through anterior approach, 4 were surgically debrided through posterior approach, 1 patient treated with anterior screw fixation and 17 patients treated with posterior pedicle screw fixations. Mean corpectomy level was 1.7±1.2 and mean fusion level was 6.8±3.8. Postoperatively, 4 patients had suffered from complications which were significantly higher in cases with more intervertebral disc involvement (p=0.005), with more vertebral body involvement (p=0.033), with more number of corpectomies (p=0.003) and with more fusion levels (p=0.023).

Conclusions:

Debridement should be performed in cases of neurological impairment, multilevel involvement or severe abscess formation. Posterior instrumentation should be added to prevent anterior implant failure in multilevel involvement.