POSTERIOR SPINAL INSTRUMENTATION FOR TUBERCULOSIS SPONDYLITIS

Objective. To study potentialities of posterior instrumentation for treatment of TB spondylitis in adults.

Material and Methods. Data on the treatment outcomes of 93 adult patients with TB spondylitis at T2–L5, which underwent radical reconstructing and restorative surgeries in the period of active inflammatory process were analyzed. In 40 cases a traditional technique was used (Group 1); in 11 cases this technique was supplemented by posterior fixation with Harrington rods or CITO-plates (Group 2) and in 42 – with CDI (Group 3). Deformity dynamics, character of complications, and changes in neural disorders and pain dynamics defined the operative effect.

Results. The absence of instrumented fixation in Group 1 was accompanied with the most significant decrease in graft sizes and most numerous complications in a zone of anterior fusion. Both these characteristics have least values in Group 3. Use of conventionally semi-rigid constructs in Group 2 caused 7 complications in a zone of posterior fixation out of 11 cases (66.4 %). There were 2 complications out of 42 cases (4.3 %) in Group 3. Short-term pain intensity decrease was achieved in all groups. However augmenting of pain syndrome was registered in a considerable number of patients in Groups 1 and 2 in a long-term period, while there were no negative long-term outcomes in Group 3.

Conclusion. Combination of radical spinal reconstruction and fixation with segmented instrumentation of the third generation for TB spondylitis provides considerable improvement of treatment results and reduction of rehabilitation and in-hospital periods.

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