Publication:

Functional and radiological outcomes after posterior decompression and pedicle screw stabilization in thoracolumbar spinal tuberculosis

Background Tuberculosis (TB) remains a major global health concern, and spinal TB (Pott’s disease) is the most common and severe form of skeletal tuberculosis, frequently involving the thoracolumbar region and potentially leading to neurological deficit, deformity, and functional impairment. Therefore, this study aimed to evaluate the functional and radiological outcomes of posterior decompression with pedicle screw stabilization in patients with thoracolumbar spinal tuberculosis.

Methods This prospective interventional study at the Department of Orthopaedic Surgery, Dhaka Medical College Hospital, Dhaka, Bangladesh (July 2017–June 2019) included 18 patients with thoracolumbar spinal tuberculosis who underwent posterior decompression and pedicle screw fixation, with pre- and postoperative evaluation using ASIA grading, radiographs, and Modified Macnab criteria; data were analyzed with SPSS v20.0 (p < 0.05).

Results Among 18 patients, most were 21–30 years (6,33.3%) and female (12,66.7%). Lesions were mainly dorsal (11, 61.1%) and lumbar (6,33.3%). Postoperative complications were rare (1, 5.6%). Neurological recovery improved (ASIA E: 9, 50%), normal ambulation in 11 (61.1%), VAS decreased 6.94→2.33, Cobb angle 28.7°→12.5°, and 17 (94.4%) achieved satisfactory functional outcomes.

Conclusions Posterior decompression with pedicle screw stabilization is a safe and effective approach that provides significant neurological, functional, and radiological improvement in thoracolumbar spinal tuberculosis.