Pott's disease surgery
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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 difficulty in breathing
- Abscess increasing in size even after 3 to 6 months of standard medical therapy
- Worsening neurological function during the period of medical therapy
- Children ≤7 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.