Spine is one of the intriguing regions in orthopaedics where the treatment of pathology has drawn much controversy. Common pathologies affecting spine are trauma, infection and malignancy. Among infections, tuberculosis is most common in vertebral body. The advent of effective combination chemotherapy and surgical intervention has drastically changed the management and the results of the disease.
Methods and Materials: We prospectively analyzed 12 patients with thoracolumbar tuberculosis with neurological deficit treated with chemotherapy for 18 months and treated with anterior decompression and stabilization with mass Miami system with iliac crest bone graft. All patients were followed up for a minimum of 2 years and the outcome was analyzed using frankel’s grading for neurological assessment, Dennis pain and work scale for post-operative pain and ability to return to their previous work.
Result: In this study we operated twelve patients. Mean age of the patient was 40 years, There were 9 paradiscal and 3 central presentations. Post operatively all the patients improved by at least one grade according to Frankel’s grading system. Post operatively 10 patients (83.4%) recovered to Frankel grade E and 2 patients (16.6%) recovered to Frankel grade D. As per Dennis pain Scale, Post operatively 8 patients (75%) had complete pain relief and 4 patients (25%) required occasional medication for pain relief. According to Dennis work scale, post operatively 83.4% patients were able to return to their previous employment (sedentary) and none of the patients were completely disabled.
Conclusion: Following middle path regimen, and using anterior approach for spinal decompression and stabilization along with iliac graft when indicated aided in early neurological recovery and return to work with minimal or no residual pain.