Aim. Many aspects of the surgical treatment of patients with tuberculosis
(TB) of the spine, including the use of instrumentation and the
types of graft, remain controversial. Our aim was to report the
outcome of a single-stage posterior procedure, with or without posterior
decompression, in this group of patients. Patients and Methods. Between 2001 and 2010, 51 patients with a mean age of 62.5 years
(39 to 86) underwent long posterior instrumentation and short posterior
or posterolateral fusion for TB of the thoracic and lumbar spines,
followed by anti-TB chemotherapy for 12 months. No anterior debridement
of the necrotic tissue was undertaken. Posterior decompression with
laminectomy was carried out for the 30 patients with a neurological
deficit. Results. The mean kyphotic angle improved from 26.1° (- 1.8° to 62°) to
15.2° (-25° to 51°) immediately after the operation. At a mean follow-up
of 68.8 months (30 to 144) the mean kyphotic angle was 16.9° (-22°
to 54°), with a mean loss of correction of 1.6° (0° to 10°). There
was a mean improvement in neurological status of 1.2 Frankel grades
in those with a neurological deficit. Bony union was achieved in
all patients, without recurrent infection. Conclusions. Long posterior instrumentation with short posterior or posterolateral
fusion is effective in the treatment of TB spine. It controls infection,
corrects the kyphosis, and maintains correction and neurological
improvement over time. . Take home message: With effective anti-TB chemotherapy, a posterior
only procedure without debridement of anterior lesion is effective
in the treatment of
