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Clinical Outcome Following Surgical Management of Thoracic Spine

Tuberculosis in Adults
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4 AUTHORS, INCLUDING:
Sudheer Ambekar

Dhananjaya I Bhat

Jaslok Hospital and Research Centre

National Institute of Mental Health and Neuro Sciences

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Available from: Sudheer Ambekar

Retrieved on: 24 September 2015

Clinical Outcome Following Surgical Management of Thoracic Spine Tuberculosis in Adults

Sudheer Ambekar MBBS; Sampath Somanna; Dhananjaya Bhat; B A Chandramouli MCh

Introduction
Spinal tuberculosis is the most
common form of extra-pulmonary
tuberculosis. Appropriate antituberculous therapy and surgical
treatment, when indicated, yields
excellent results.
Methods
Adult patients over 18 years of age,
who have undergone surgery for
thoracic spine tuberculosis at
NIMHANS from 2000-2007, were
selected and their clinical, radiological
characteristics and outcomes
assessed.

Results
The age of the patients ranged from
19 to 77 years with a mean of 40
years and almost equal distribution
between the two sexes. The duration
of symptoms ranged from 15 days to
2.5 years with a mean of 7 months.
The most common symptom at
presentation was lower limb weakness
(96.7%). Bladder involvement was
seen in 54% of the patients. Most of
the patients had severe symptoms at
presentation (77.3%). Two level
vertebral body involvement was seen
commonly (46%) with the midthoracic spine being involved in more
than half of the patients (52%).
Various surgical approaches were used
depending upon a number of factors,
the posterolateral extracavitary
approach being the commonest
(51.8%). Follow-up ranged from 1
month to 6 years with a mean of 15.5
months. There was significant
improvement in the functional
outcome in patients with both severe
as well as mild symptoms in 90.4% of
the patients at follow up. There was
no significant difference in functional
outcome between patients who
underwent instrumented fusion and
those who underwent uninstrumented
fusion.
Conclusions
Patients with even severe symptoms
and those who presented late during
the course of the disease have a good
functional outcome comparable to that
of patients with mild symptoms and
early presentation respectively.

Learning Objectives
To analyze the clinical and radiological
characteristics and outcome in
patients who have undergone surgery
for thoracic spine tuberculosis.

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