Spinal tuberculosis is one of the most common presentations of skeletal tuberculosis. It is one of the major health issues of developing countries as it is associated with significant morbidity and mortality. Pott's paraplegia is a dreaded complication which can result in permanent neurological deficit, unless treated by timely intervention. We evaluated the efficacy of transpedicular decompression and functional recovery in patients of spinal tuberculosis with neurological deficit.

A cohort of 23 patients (15 males and 8 female) with diagnosed spinal tuberculosis and having an average age of 37.5±8.4 years, satisfying our inclusion and exclusion criteria's and giving written informed consent were recruited in our study. All patients were managed by transpedicular decompression and fusion with posterior instrumentation. All the patients were followed up clinically, radiologically and hematologically. Patients were followed up at every six weeks for 4 months and thereafter at three monthly intervals to assess the long term outcomes and complications. Neurological evaluation was done by Frankel grading. Functional outcome was assessed by Visual Analog Score (VAS) and Owestry Disability Index score (ODI score).

All the patients were followed for a minimum of 27 months. At the final follow-up, there was a statistically significant improvement in VAS score and ODI score. Out of 23 patients, all except three patients showed neurological recovery.

We observed that transpedicular decompression is safe and effective approach for management of spinal tuberculosis as it allows adequate decompression of spinal cord while pedicular instrumentation provides stable spinal fixation and helps in early rehabilitation.

Purpose: A study was done to determine the duration of spinal shock in spinal cord injury (SCI)- the first reflex to return while recovering from spinal shock & the factors influencing duration of spinal shock.

Method: 116 patients in spinal shock following SCI were included. A detailed neurological examination of sensory, motor and reflex activity was done everyday till the patients were out of spinal shock. The duration of spinal shock by appearance of any reflex, the first reflex to return & the influence of variable factors on duration of spinal shock were studied The mean duration of spinal shock was studied on factors as age, sex, nutritional status (haemoglobin, triceps skin fold thickness, & mid arm circumference), occupation (educated/uneducated, trained/untrained), mode of trauma, duration of injury, skeletal level of injury, neurological level, associated injuries, treatment modality and development of complications during spinal shock

Results: 59 patients (51%) had spinal shock duration of < 1 week; 10 (8.6%) recovered between 1st and 2nd week, 15 (13%) between 2nd and 3rd week & 4 (5%) had recovered after 3 weeks. 28 patients (25%) remained in spinal shock till discharge (6 weeks). In 76 patients (85.4%) anal wink (AW) was the first reflex to return either alone or simultaneous with BC/DPR. In none of the patients BC or DPR appeared before AW. In 7 patients (9%) cremastric reflex was first reflex to return, in 3 pathological reflexes & in 2 deep tendon reflexes (ankle) were the first to return.

Conclusion: On statistical analysis mean duration of spinal shock was shorter in children as compared to adults, shorter in malnourished as compared to normal, shorter in untrained as compared to trained, shorter in patients admitted early and shorter in patients who developed complications as compared to those who did not. Mean duration of spinal shock increased progressively down the spine and spinal cord as we move from cervical to thoracic to lumbar region. Mean duration of spinal cord was not influenced by sex of patient, associated injuries to other parts of body and by different modes of treatment