, Volume 103, Issue 3, pp 243–249 | Cite as

Single-stage anterior debridement, posterior instrumentation and global fusion in thoracic and thoracolumbar tubercular spondylodiscitis

  • S. P. Mohanty
  • M. Pai KanhangadEmail author
  • B. Yogesh Kumar
  • A. Singh
Original Article



The present study evaluated the clinical and radiological outcomes in patients with tuberculosis of the thoracic and thoracolumbar spine, treated by an operative technique in which anterior debridement with posterior instrumentation and global fusion was performed through a single-stage posterior approach.


Ninty-seven patients with spinal tuberculosis, between T1 and L1, in whom anterior debridement, bone grafting, with posterior instrumentation and fusion was performed through a single-stage posterior approach, with a minimum follow-up of 2 years, formed the basis of this study. During each follow-up, neurological recovery was assessed using modified American Spinal Injury Association grading, healing of the disease was assessed by appearance of sclerosis and interbody fusion and the degree of kyphotic deformity was analysed using the modified Konstam’s angle.


Two hundred and twenty-six lesions were found in the radiographs of 97 patients with 28.9% of them having multiple lesions. The mean ± SD preoperative, post-operative, and 2-year follow-up kyphotic angle were 49.5 ± 18.4°, 22.6 ± 7.1° and 24.5 ± 7.6°, respectively, and showed significant kyphosis correction (P < 0.01). Sclerosis was seen as early as 3 months in 82(84.5%) patients whereas interbody fusion started appearing at the end of 6 months in 38.14% of patients and peaked at 1 year. All patients recovered neurologically, with no significant loss of kyphosis correction, at final follow-up.


The surgical technique described in this study had favourable clinical and radiological outcomes. Early surgery helps in having a definitive diagnosis and detects the presence of drug-resistant strains.


Spinal tuberculosis Anterior debridement Posterior instrumentation Global fusion 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Institutional ethical clearance was obtained before starting the study.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Human and animal rights

This article does not contain any studies with animals performed by any of the authors.


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Copyright information

© Istituto Ortopedico Rizzoli 2018

Authors and Affiliations

  1. 1.Department of Orthopaedics, Division of Spine Surgery, Kasturba Medical CollegeManipal Academy of Higher EducationManipalIndia

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