Outcome of Dual Stability and Decompression through Single Posterior Approach in Tuberculosis of Dorsolumbar Spine


  • Waqar Ahmed
  • Khizer Ghalib
  • Adeel Hamid
  • Muhammad Shakeel
  • Muhammad Qasim
  • Muhammad Khalid Syed et al.




Dual stability, decompression, Frankel neurological grading


Objective:  To evaluate the outcome of dual stability and decompression through a single posterior approach in patients with tuberculosis of the dorsolumbar spine in terms of Oswestry Disability Index and Frankel Neurological Grading.

Material and Methods:  It was a prospective cohort study involving 34 patients with tuberculosis of the dorsolumbar spine who underwent dual stability and decompression through a single posterior approach. Follow-ups were done at 2nd, 6th, 12th and 16th weeks. The outcome was assessed using the Oswestry Disability Index and Frankel Neurological Grading.

Results:  In 34 patients, the mean age was 36.59±13.51 years. There were 20 (58.8%) males and 14 (41.2%) females. There were 9 (26.5%) patients who had dorsal spine tuberculosis, while lumbar spine TB and dorso-lumbar spine TB were diagnosed in 13 (38.2%) and 12 (35.3%) patients respectively. The mean surgery time was 4.20±0.66 hours. According to the Oswestry Disability Index, before surgery, 2 (5.9%) patients had minimal disability while after 16 weeks of follow-ups, these numbers increased to 23 (67.7%) showing statistically significant improvements. According to Frankel Neurological Grading, before surgery, 3 (8.8%) patients had normal function while after 20 weeks of follow-up following surgery, 20 (58.9%) had normal functions.

Conclusion:  Dual stability and decompression through a single posterior approach were found to have good functional and fusion outcomes according to the Oswestry Disability Index and Frankel Neurological grading.


Kandwal P, Vijayaraghavan G, Jayaswal A. Management of Tuberculous Infection of the Spine. Asian Spine J. 2016;10(4):792-800.

Fisahn C, Alonso F, Hasan GA, Tubbs RS, Dettori JR, Schildhauer TA, et al. Trends in spinal surgery for Pott’s disease (2000-2016): An overview and bibliometric study. Global Spine J. 2017;7(8):821-828.

Benzagmout M, Boujraf S, Chakour K, Chaoui MEF. Pott's disease in children. Surg Neurol Int. 2011;2:1.

Maila SK, Rao AL, Sunnadkal RS, Krishna M. Evaluation of implant stabilization in tubercular spondylodiscitis: A prospective study. Int J Res Med Sci. 2015;3(10):2647-2653.

Khan S, Zahir MZ, Khan J, Mahsud ZS. Spectrum of MRI findings in spinal tuberculosis. KJMS. 2016;9(1):96-99.

Varatharajah S, Charles YP, Buy X, Walter A, Steib JP. Update on the surgical management of Pott’s disease. Orthoped Traumatol Surg Res. 2014;100(2):233-239.

Golwala P, Kapoor C, Shah M, Merh A, Kansagra A. A case of Koch's spine treated with modified transpedicular vertebral curettage and posterior fixation: A novel technique. Cureus. 2016;8(12):e915.

Ramos RDLG, Goodwin CR, Abu-Bonsrah N, Bydon A, Witham TF, Wolinsky JP, et al. The epidemiology of spinal tuberculosis in the United States: An analysis of 2002–2011data. J Neurosurg Spine. 2017;26(4):507-512.

Shah K, Nene A. Tuberculosis of the spine: The current clinical landscape. Astrocyte. 2017;4(2):94-99.

Zeng H, Zhang P, Shen X, Luo C, Xu Z, Zhang Y, et al. One-stage posterior-only approach in surgical treatment of single-segment thoracic spinal tuberculosis with neurological deficits in adults: a retrospective study of 34 cases. BMC Musculoskelet Disord. 2015;16:186.

Wang B, Kong L, Zhu Z, Gao W, Guo H, Wang X, et al. Recurrent complex spinal tuberculosis accompanied by sinus tract formation: Causes of recurrence and clinical treatments. Sci Rep. 2018;8(1):6933.

Islam MA, Rahman MN, Goni MF. Surgical outcome of posterior decompression, posterolateral fusion and stabilization by pedicle screw and rod in thoracolumbar tuberculosis. Bangabandhu Sheikh Mujib Med Univ J. 2017;10(2):89-92.

Rasouli MR, Mirkoohi M, Vaccaro AR, Yarandi KK, Rahimi-Movaghar V. Spinal tuberculosis: Diagnosis and management. Asian Spine J. 2012;6(4):294-308.

Abbas A, Rizvi SRH, Mahesri M, Salahuddin HRA. Conservative management of spinal tuberculosis: Initial series from Pakistan. Asian Spine J. 2013;7(2):73-80.






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