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Outcomes of Dorsolumbar and Lumbar Spinal Tuberculosis Treated by Minimally Invasive and Open Techniques: A Prospective Comparative Study

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Abstract

Purpose of Study

To compare the outcomes of minimally invasive and open techniques in the surgical management of dorsolumbar and lumbar spinal tuberculosis (STB).

Methods

Skeletally mature patients with active STB involving thoracolumbar and lumbar region confirmed by radiology (X-ray, MRI) and histopathological examination were included. Healed and mechanically stable STB, patients having severe hepatic and renal impairment, coexisting spinal conditions such as ankylosing spondylitis and rheumatoid arthritis, and patients unwilling to participate were excluded from the study. The patients were divided in to two groups, group A consisted of patients treated by MIS techniques and group B consisted of patients treated by open techniques. All the patients had a minimum follow-up of 24 months.

Results

A total of 42 patients were included in the study. MIS techniques were used in 18 patients and open techniques were used in 24 patients. On comparison between the two groups, blood loss (234 ml vs 742 ml), and immediate post-operative VAS score (5.26 vs 7.08) were significantly better in group A, whereas kyphotic correction (16° vs 33.25°) was significantly better in group B. Rest of the parameters such as duration of surgery, VAS score, ODI score and number of instrumented levels did not show significant difference between the two groups.

Conclusion

MIS stabilization when compared to open techniques is associated with significant improvement in immediate post-operative VAS scores. The MIS approaches at 2-year follow-up have functional results similar to open techniques. MIS is inferior to open techniques in kyphosis correction and may be associated with complications.

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Authors and Affiliations

  1. Department of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

    Syed Ifthekar, Kaustubh Ahuja, Samarth Mittal, Gagandeep Yadav & Pankaj Kandwal

  2. Department of Orthopaedics, All India Institute of Medical Sciences, Bibinagar, Hyderabad, India

    Syed Ifthekar

  3. BLK Max Speciality Hospital, Delhi, India

    Samarth Mittal

  4. Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

    Jiitender Chaturvedi

  5. Department of Trauma Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

    Bhaskar Sarkar

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Correspondence to Pankaj Kandwal.

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Ifthekar, S., Ahuja, K., Mittal, S. et al. Outcomes of Dorsolumbar and Lumbar Spinal Tuberculosis Treated by Minimally Invasive and Open Techniques: A Prospective Comparative Study. JOIO (2024). https://doi.org/10.1007/s43465-024-01123-5

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