Pott's disease surgery: Difference between revisions
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==Overview== | ==Overview== | ||
==Surgery== | ==Surgery== | ||
===Indications for Surgery=== | |||
Patients with: | |||
*Neurological deficits | |||
*Potential mechanical instability | |||
*Kyphosis leading to sagittal imbalance or severe kyphosis ≥60° | |||
*Large thoracic spine abscess casing esophageal obstruction or cervical abscess causing dyspnea | |||
*Abscess increasing in size even after 3 to 6 months of standard medical therapy | |||
*Worsening neurological function during the period of medical therapy | |||
*Children ≤ seven years of age, with three or more affected vertebral bodies | |||
===Surgical Options=== | |||
*Surgical therapy for spinal tuberculosis is by decompression of the cord with debridement of the infected tissue via the anterior or anterolateral approach. | |||
*Anterior transposition of cord with shaving of the internal gibbus can be performed in patients with severe kyphotic deformities with compression of the cord. | |||
*Laminectomy for decompression is contraindicated in cases with anterior spinal tuberculosis, as it increases the unstability of the spine. | |||
==References== | ==References== | ||
Revision as of 19:14, 23 March 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Surgery
Indications for Surgery
Patients with:
- Neurological deficits
- Potential mechanical instability
- Kyphosis leading to sagittal imbalance or severe kyphosis ≥60°
- Large thoracic spine abscess casing esophageal obstruction or cervical abscess causing dyspnea
- Abscess increasing in size even after 3 to 6 months of standard medical therapy
- Worsening neurological function during the period of medical therapy
- Children ≤ seven years of age, with three or more affected vertebral bodies
Surgical Options
- Surgical therapy for spinal tuberculosis is by decompression of the cord with debridement of the infected tissue via the anterior or anterolateral approach.
- Anterior transposition of cord with shaving of the internal gibbus can be performed in patients with severe kyphotic deformities with compression of the cord.
- Laminectomy for decompression is contraindicated in cases with anterior spinal tuberculosis, as it increases the unstability of the spine.