Surgical Outcome of Spinal Tuberculosis Regarding Pain, Neurological Deficit, and Spinal Instability


  • Ehtisham Ahmed Khan Afridi
  • Ahsan Aurangzeb Khan
  • Saadia Maqbool
  • Nusrat Shaheen



Objective:  The most prevalent type of skeletal TB, which accounts for nearly half of all cases, affects the spinal column. Regarding pain, neurological deficit, and spinal instability, the study sought to determine the surgical outcome of spinal tuberculosis.

Material and Methods:  This study was conducted in the Department of Neurosurgery, Ayub Teaching Hospital. A total of 42 patients with ages ranging from 24 – 66 years were included in the study. Information about the patient was gathered to determine indications (neurological impairments) about the ASIA Grading Scale and frequently affected areas.

Results:  Commonest location was a thoracolumbar junction in 42.8%, followed by the lumbar spine in 23.8%. The pain was found in all subjects. The main indication of surgery was neurological deficit which is seen in 57% of patients followed by spinal instability or deformity in 16.6% of patients and patients with failed chemotherapy in 4.7% of patients. The preoperative KA was between 30 – 60º with a mean of 43.06 ± 4.11 degrees and 9.45 ± 3.99 degrees for postoperative KA (p-value < 0.0001). Most fixations of the cord were done through a posterior approach that was in 83.3% of patients. The neurological improvement according to ASIA grading was seen in 95.2% and no improvement was seen in 4.7% of patients upon 3 months follow-up.

Conclusion:  Surgical treatment of the caries spine improves pain, lowers neurological compression, and successfully reverses deformities like kyphosis, resulting in better clinical results. It also helps to remove the Tuberculous burden from the body.


Tuli SM. Tuberculosis of the skeletal system: Bones, joints. Spine and Bursal. Rev Reprint: Jaypee Brothers Medical Publishers: 1993. P. 268.

Rajasekaran S, Soundarajan DCR, Shetty AP, Spinal tuberculosis: Current Concepts. Global Spine Journal 2018;8(45):965-1085

Luk KDK. Tuberculosis of the Spine in the new millennium. Eur Spine J.1999; 8:338-45.

James J. The Discovery of the Tubercle Bacillus by Robert Koch: a milestone for 123 years (in Dutch). Ned Tijdschr Geneeskd.2005;149:2921-6.

Kulchavenya E. Extrapulmonary tuberculosis: are statistical reports accurate? Ther Adv Infect Dis.2014; 2:61-70.

Estves S, Catarino I, Copes D, Sousa C. Spinal tuberculosis: Rethinking an old Disease. J Spine 2017; 6:358.

Gautam MP Karki P, Rijal S, Singh R. Pott’s Spine and paraplegia. JNMA J Nepal Med Assoc 2005;44: 106-15.

Garg RK, Somavarishi DS. Spinal tuberculosis: A Review. J Spinal cord Med 2011; 34:440-54.

Jain AK, Kumar J. Tuberculosis of Spine: Neurological deficit. Eur Spine J 2013; 4:624-33.

Mateo L, Ruiz Manzano J, Olive A, Manterola JM, Perez R. Osteoarticular tuberculosis. Study of 53 cases. Med Clin(Barc)2007; 129:506-9.

Kandwal P, Vijayrazhavan G, Jayaswal A. Management of tuberculosis infections of the Spine. Asian Spine J 2016; 10:792-800.

Raut S. Spinal tuberculosis. Recent trends of surgical management in the Modern Era. J. Clinical Orthopedics and trauma Care 2022;4(2):10.

Rezai AR, Lee M, Copper PR, Errico TJ, Koslow M. Modern management of Spinal tuberculosis. Neurosurgery 1995; 36:87-97.

Park DW, Sohn JW. Kim EH, Cho DI, Lee JH, Kim KT. Outcome and management of Spinal tuberculosis according to the severity of disease: A retrospective Study of 137 adult patients at Korean teaching hospital. Spine (Phila Pa 1976) 2007; 232: E130-5.

Medeiros RS, Abdo RC, de Paula FC, Narazaki DK, Correia LS, Araujo MP. Treatment of Spinal tuberculosis: Conservative or surgical? Acta Ortop Bras 200; 15:128-31.

Pertuiset E, Beaudreuil J, liote F. Spinal tuberculosis in adults: a study of 103 cases in a developed country, 1980-1994.Medicine (Baltimore).1999;78:309-20.

Bodapati P, Vemula R, Mohammad A, Mohan A. Outcome and management of spinal tuberculosis according to severity at a tertiary referral center. Asian Journal of Neurosurgery. 2017;12(03):441-6.

Liu Z, Zhang P, Zeng H, Xu Z, Wang X. A comparative study of single-stage transpedicular debridement, fusion, and posterior long-segment versus short-segment fixation for the treatment of thoracolumbar spinal tuberculosis in adults: minimum five-year follow-up outcomes. International Orthopaedics. 2018;42(8):1883-90.

Deng L, Zhang YW, Xiong LY, Zhang SL, Ni WY, Xiao Q. Extreme lateral interbody fusion and percutaneous pedicle screw fixation in the minimally invasive treatment of thoracic tuberculosis. Journal of International Medical Research. 2020;48(5):0300060520925992.






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