Volume 16 | Issue 1 | January-March 2021 | Page 24-30 | Sameer Ruparel, Ankit Patel, Vishal Kundnani, Saijyot Raut
Authers: Sameer Ruparel [1], Ankit Patel [2], Vishal Kundnani [2], Saijyot Raut [2]
[1] Consultant Spine Surgeon, Jaslok and Global Hospitals, Mumbai.
[2] Department of Orthopaedics, Lilavati and Bombay Hospitals, Mumbai.
Address of Correspondence
Dr. Vishal Kundnani,
Room No 3 , OPD block, Lilavati Hospital & Research Centre, Reclamation, Bandra West, Mumbai, Maharashtra 400050.
E-mail: kundnanivishal@yahoo.co.in
Abstract
Principles of treatment for surgical management of spinal tuberculosis has been ever changing over the years. With advances in medical management and surgical techniques, the aim is to achieve optimum functional outcomes with minimum patient morbidity. Development of effective anti-tuberculous drugs and extensive trials over the years have now finally laid down basic principles and indications of this ‘medical disease’. The principles of surgical treatment include optimum debridement and decompression, adequate bone on bone contact for fusion, providing immediate stability for early mobilization with an approach which causes least morbidity coupled with effective ATT. To achieve these goals either anterior/ posterior / combined approaches can be utilized with each having their advantages and disadvantages. Similarly, the treatment principles for healed TB spines are entirely different due to altered pathology and biomechanics. However, to reduce the morbidity of available surgical techniques, recent success of Minimally Invasive Spine Surgery has prompted spine surgeons to utilize them for the treatment of spinal tuberculosis. Modern technologies like endoscopic approaches, percutaneous biopsies and pedicle screw fixation, expandable muscle splitting retractors and intervertebral cages, intra operative neuromonitoring and navigation have recently revolutionized the surgical management of spinal tuberculosis. This manuscript focusses on the development of recent surgical principles, techniques and trends for the treatment of Koch’s spine.
Keywords: Spinal Tuberculosis, Koch’s spine, recent advances, surgery, surgical management.
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| How to Cite this article: Ruparel S, Patel A, Kundnani V, Raut S, Kundnani V. Spinal tuberculosis recent trends of surgical management in modern era. Journal of Trauma and Orthopaedic Surgery January-March 2021;16(1): 24-30. |