Restoration of Normal Anatomy after Spinal Titanium Cage Fixation of Dorsal Spine in Caries

Muhammad Zeb Tunio, Abdul Malik Shaikh, Kashif Tabani, Faisal Nazir Hussain Sheikh, Irfan Mehboob

ABSTRACT

Objective: To observe the improvement in restoration of normal anatomy after spinal titanium mesh cage fixation in caries of dorsal spine.

Methods: This study was the observational clinical study conducted from 2004 to 2005. Total 30 patients with tuberculosis of dorsal spine with one or two adjacent collapsed vertebrate and Kyphotic angulation >25º were included, Patients were excluded from study below the age of 10 years and above of 70 years, more than three vertebral collapses, severe Osteoporosis with collapse patients unfit for general anesthesia and surgery due to the cardiac and pulmonary failure.

Results: Thirty cases of dorsal caries spine were operated.  Deformity of spine was noted in all patients. On lateral X-ray it was recorded in degrees by Cobb method. Preoperative mean angle was 42.30±5.81° P<0.05 range was 24 to 55 degrees. Out of 30 patients, 8 (26.7%) had range of 24° to 35°, 20 patients (66.7%) had the range of 36° to 45° and 2 patients (6.6%) had range of angle from 46 to 55 degrees. Before surgery 42º.30º±5.81 p value <0.05 After Surgery, Immediate after surgery 37.70º±6.25º p value >0.05, 1 month 35.80º±6.43º >0.05, 3 months 33.77º±6.32º p value >0.05, 6 months 31.83º±6.05º p value >0.05, 9 months 30.60º±6.01º p value >0.05, 12 months 27.97º±6.11º p value >0.05.

Conclusion: Current recommendation for management of caries spine is operative intervention in progressive paraplegic patients who are not responding to chemotherapy. Therefore current study have followed the above recommendations of early decompression and correction of deformity for caries spine of early onset and achieved desired results. There are many methods available for fusion of spine but the insertion of newly designed titanium mesh cage used in this study with bone graft is one of the most effective methods in correction of deformity.