Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Spine
Abstract number: 26282
MANAGEMENT OF SUBAXIAL CERVICAL SPINE TUBERCULOSIS:
Dharmendra SINGH
Indian Spinal Injuries Center, New Delhi (INDIA)
OBJECTIVE: To evaluate the efficacy of anterior debridement, bone grafting and
instrumentation in patients with subaxial cervical spine tuberculosis in reconstruction
of the spine, providing pain relief, neurological recovery and prevention of deformity.
METHODS: Twenty two patients with subaxial cervical spine tuberculosis involving
C3 to C7 region and neurological complication ( 2 ASIA-B, 15 ASIA-C, 5 ASIA-D)
were treated by anterior debridement, bone grafting and plate fixation over a period
of five year. A four-drug antituberculosis regimen was administered for a period of 18
month. The follow-up ranged from 18 to 60 months (mean 32 months). Clinical and
radiological assessment using flexion and extension radiographs was performed at 3
months, 6 months, 12 months and 24 months respectively to show any evidence of
instability or nonunion. RESULTS: All cases had bony fusion. There were no
increased neurological deficits. Out of 22 patients with neurological manifestations,
20 showed complete recovery (ASIA-E) and two marked improvements (ASIA-D).
The neck pain score based on a visual analog scale (1-10) changed from a preoperative
average of 7 to 2 at follow-up after 3 months. Kyphosis improved from 18.2
degrees (5-45 degrees) preoperatively to 2 degrees (-6-12 degrees) at the latest
follow-up. CONCLUSIONS: Anterior debridement, bone grafting and reconstruction
using titanium plates and screws for stabilization of the subaxial region tuberculosis
is a useful adjunct in preventing neurological deficit and kyphotic deformity. A
satisfactory segmental stability and fusion is achieved by this technique.
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