Anterior Versus Posterior Fixation in Thoracic Tubercular Spine

Tubercular spine has been an age old problem for management. Spine fixation in skeletal tuberculosis has evolved in the last decade, which not only helps in early mobilization of the patient but also prevents late problems of chronic pain and progressive kyphosis. Transpedicular fixation and hartshill loop is done mainly through posterior approach while transthoracic, transmanubrial and transaxillary are the methods for anterior approach. In this prospective study of 30 patients which were operated during last 4 years, some via anterior and majority via posterior approach. The results were evaluated and it was concluded that posterior approach had many advantages over anterior approach This includes a three column fixation which is not possible with anterior approach. This helps in early mobilization of the patient. Posterior approach has a lesser morbidity than anterior approach, requires lesser duration of hospital stay and surgical risks of anterior are minimized. For thoracic 1 to thoracic 5 vertebra, posterior approach is not good because of small sized pedicles and also there is more danger of damage to major vessels. In these levels, anterior approach is more suitable. The posterior approach has an edge over anterior approach in many aspects.