Anterior Lumbar Fusion in Pott's Disease

Abstract

Although most lumbar lesions associated with spinal tuberculosis can be satisfactorily resolved with nonoperative treatment, there are cases in which surgery is indicated. Between July 1982 and December 2003 we retrospectively reviewed 51 patients who were operated by anterior débridement and fusion. Twelve patients were lost to followup and one died due to inferior vena cava tear. Followup of 38 patients ranged from 2 to 10 years (average 4 years). There were 22 male and 16 female patients, average age 35 years (range, 8-65 years); upper lumbar area (L1-L3) was involved in 17 cases, lower lumbar (L3-L5) in 19 and lumbosacral area in two patients; 28 patients had two-body and 10 had three-body involvement. In 35 patients we performed single stage débridement and fusion. More recently three patients had two stage (instrumentation plus débridement and fusion) procedure. Followup was based on subjective relief, recovery of neural deficit and consolidation at fusion site. Thirty-six out of 38 patients had complete relief from pain and discomfort along with radiographic fusion. Five patients who had neural deficit recovered completely. Surgical treatment of lumbar spinal tuberculosis in selected cases gives satisfactory results. Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.