Pott's disease surgery: Difference between revisions
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Patients with: | Patients with: | ||
*Neurological deficits | *Neurological deficits | ||
*Potential mechanical instability | *Potential [[mechanical instability]] | ||
*Kyphosis leading to sagittal imbalance or severe kyphosis | *[[Kyphosis]] leading to sagittal imbalance or severe [[kyphosis ]] ≥60° | ||
*Large thoracic spine abscess casing esophageal obstruction or cervical abscess causing | *Large [[thoracic spine]] [[abscess]] casing [[esophageal obstruction]] or [[cervical]] [[abscess]] causing [[difficulty in breathing]] | ||
*Abscess increasing in size even after 3 to 6 months of standard medical therapy | *[[Abscess]] increasing in size even after 3 to 6 months of standard medical therapy | ||
*Worsening neurological function during the period of medical therapy | *Worsening [[neurological function]] during the period of medical therapy | ||
*Children | *Children ≤7 years of age, with three or more affected [[vertebral bodies]] | ||
===Surgical Options=== | ===Surgical Options=== | ||
*Surgical therapy for spinal tuberculosis is by decompression of the cord with debridement of the infected tissue via the anterior or anterolateral approach. | *Surgical therapy for spinal tuberculosis is by decompression of the cord with debridement of the infected tissue via the anterior or anterolateral approach. | ||
Revision as of 17:23, 24 March 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
Indications for Surgery
Patients with:
- Neurological deficits
- Potential mechanical instability
- Kyphosis leading to sagittal imbalance or severe kyphosis ≥60°
- Large thoracic spine abscess casing esophageal obstruction or cervical abscess causing difficulty in breathing
- Abscess increasing in size even after 3 to 6 months of standard medical therapy
- Worsening neurological function during the period of medical therapy
- Children ≤7 years of age, with three or more affected vertebral bodies
Surgical Options
- Surgical therapy for spinal tuberculosis is by decompression of the cord with debridement of the infected tissue via the anterior or anterolateral approach.
- Anterior transposition of cord with shaving of the internal gibbus can be performed in patients with severe kyphotic deformities with compression of the cord.
- Laminectomy for decompression is contraindicated in cases with anterior spinal tuberculosis, as it increases the unstability of the spine.