Abstract
Objective: The most dreaded and crippling complication of spinal tuberculosis is pott’s paraplegia.
The use of instrumentation in the presence of infection is usually deferred for the fear of formation of a focus, persistence bio material centered infection, preferential bacterial colonization and production of a bio-film (glycocalyx) which protects them from host defenses and chemotherapeutic agents. Fortunately, mycobacterium tuberculosis is less adhesive and produces less bio-film than other bacteria and the likelihood of persistence infection in the presence of implants is smaller.
Design: The present study is being conducted to study the positive and negative effects of decompression with instrumentation and to analyze and compare the results of conservative treatment, surgical decompression and decompression with instrumentation.
Participants/Methods: The study was conducted in 56 patients. All patients of Pott’s Paraplegia admitted during June,02 to June,03 were included. According to the treatment given the patients were divided into three groups:
Group I – Conservative treatment.
Group II – Surgical decompression only
Group III – Surgical decompression combined with instrumentation
Results: At different time intervals almost equal neurological recovery was found in group II and group III while slow recovery in group I.
The mean ambulatory time was almost equal in group I and group II while very low (less than a week) in group III.
Pain function score grade shifted towards excellency with time in all groups-- p=4.48 x 10-3 in group I, p=4.44 x 10-7 in group in II and p = 4.49 x 10-7 in group III.
The change from grade B to grade A is quick in group III. Excellent grade is maximum (77.8%) in group III and nil in group I (p value at 6 in = 1.22 x 10-3 which is statistically significant.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
