Paraplegia in pott’s spine: evidence-based management strategy

Volume 16 | Issue 1 | January-March 2021 | Page 31-38 | Shailesh Hadgaonkar, Divakar Modipalli, Siddarth Aiyer, Pramod Bhilare, Ajay kothari, Parag Sancheti


Authers: Shailesh Hadgaonkar [1], Divakar Modipalli [1], Siddarth Aiyer [1], Pramod Bhilare [1], Ajay kothari [1], Parag Sancheti [1]

[1] Department of spine and Neurosciences, Sancheti Institute for Orthopaedics and Rehabilitation Shivajinagar, Pune, Maharashtra, India 41103.

Address of Correspondence
Dr. Shailesh Hadgaonkar,
Department of spine and Neurosciences, Sancheti Institute for Orthopaedics and Rehabilitation Shivajinagar, Pune, Maharashtra, India 41103
E-mail: drshadgaonkar@gmail.com.


Abstract

Study Design: Review article
Objective: To present a review of literature on the epidemiology, pathophysiology, diagnosis and outline evidence-based management strategy for paraplegia in Pott’s spine
Methods: A systematic literature search was performed using PubMed systematic Reviews. Studies published over the last 20 years were analysed and conclusions were drawn. The search was conducted using key words “Tuberculosis of Spine”, “Paraplegia” and “Management”.
Results: Early diagnosis and timely initiation of treatment is the key to successful treatment of Spinal Tuberculosis (STB) with neurological deficit. Surgery along with appropriate chemotherapy is the mainstay of treatment when STB is complicated by neurological deficits. In cases of late onset neurological deficit, the decision regarding the surgical approach is based on the severity and location of the deformity, and the nature of pathology causing the neurological deficits. Surgery is warranted in case of the early-onset spinal TB complicated by neurological deficits, disease compromising the spinal stability, spinal deformity and in patients presenting with progressive neurological deficits. Surgery for late onset neurological deficits and deformity are associated with complications like worsening of the neurological deficits, persistence of the deformity and suboptimal outcome.
Conclusions: Tuberculosis is a medical disease and chemotherapy is the cornerstone of treatment. Surgery in early disease for neurological deficits/spine instability is associated with good neurological recovery. Surgery in late onset disease is necessary to correct
deformity and arrest progression of neurological deficits, However is associated with inferior outcomes
Keywords: Spinal tuberculosis, Pott’s paraplegia, Neurological deficits, chemotherapy, Late onset paraplegia, kyphosis, Surgical approach.


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How to Cite this article: Hadgaonkar S, Modipalli D, Aiyer S, Bhilare P, kothari A, Sancheti P. Paraplegia in pott’s spine: evidence-based management strategy. Journal of Trauma and Orthopaedic Surgery January-March 2021;16(1): 31-38.

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