Background: Though spinal tuberculosis has a predilection for the dorsal and lumbar spine, a high percentage of morbidity and mortality is associated with cervical tuberculosis. Cervical tuberculosis accounts for about 10% of cases, with the major concerns being quadriparesis/quadriplegia and kyphotic deformity. Herein we describe our experience with the use of anterior instrumentation with titanium implants in 46 patients with subaxial tuberculosis.
Materials and methods: Included in the study were a total of 46 patients with subaxial cervical (C3-C7) and upper dorsal (D1-D3) tuberculosis who underwent operations with anterior debridement, decompression, bone grafting, and anterior instrumentation by a single surgeon at our institute between January 2007 and December 2014. A review of the demographic data, medical records, and x-rays before and after surgery and at subsequent follow-ups was performed retrospectively from the departmental database.
Results: Neurological involvement in the postoperative period was seen in 29 of the 30 patients, 26 of whom showed complete neurological recovery. The Cobb angle at presentation ranged from 2°-58° of kyphosis with an average kyphosis of 15.4°. The average lordosis after surgery was found to be 17.5° (ie, a mean correction of 32.9°).
Conclusions: Anterior instrumentation of subaxial cervical tuberculosis with titanium implants provides good correction of kyphosis and provides reasonable neurologic recovery in patients and ensures a long-lasting functional outcome.
Level of evidence: 4.
Keywords: anterior cervical instrumentation; subaxial cervical spine; tuberculosis.
This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS.