Transpedicular Surgical Decompression of Dorsal Spinal Tuberculosis (Pott’s Disease) with Vertebral Collapse without Fixation

Tuberculosis of spine is prevalent in developing countries and is considered a disease affecting people from low socioeconomic groups [1-9]. Over the period of last three to four decades, chemotherapy for tuberculosis and various advanced surgical options which include fixation of the spinal segments with newer prosthetic implants have changed the outlook [1, 10]. Another new development in the field of prosthetic implants for spinal surgeries has occurred: increasing use of Magnetic Resonance (MR) imaging compatible and internationally acceptable implants (made of titanium or bio-degradable materials), which are very costly and simultaneous phasing out of older and cheaper implants (made of stainless steel) [1, 11-13]. This has led to a strange situation for the patients of spinal tuberculosis because they cannot afford the cost of the implants even if they get a chance of admission in poorly financed public sector hospitals which do not provide free prosthetic spinal or for that matter any costly prosthetic implants [14-17]. Unlike other levels, sternum and rib cage provide additional stability to the thoracic spine, and this additional support to the thoracic spine may help in selecting surgical approach for treatment of spinal tuberculosis of dorsal spine [18]. Role of decompressive surgery along with various methods of fixation in a patient of dorsal Pott’s disease with vertebral collapse and cord compression with significant neurological deficit is explicitly accepted in the literature; however, reports of decompressive surgery alone in dorsal Pott’s disease with vertebral collapse are rare [19-21]. Transpedicular Surgical Decompression of Dorsal Spinal Tuberculosis (Pott’s Disease) with Vertebral Collapse without Fixation