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Chapter-24 Posterior Approaches for Management of Spinal Tuberculosis

BOOK TITLE: Spinal Infections and Trauma

Author
1. Zaveri Gautam
ISBN
9789350250754
DOI
10.5005/jp/books/11196_24
Edition
1/e
Publishing Year
2011
Pages
12
Author Affiliations
1. Jaslok and Fortis Hospitals, Mumbai, Maharashtra, India and DY Patil Medical College, Ghatkopar (E), Mumbai, Maharashtra, India, Jaslok Hospital and Research Center, Mumbai, Maharashtra, India, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
Chapter keywords

Abstract

Posterior and posterolateral approaches to the spine are designed to allow anterior debridement and reconstruction whilst also permitting posterior instrumentation and decompression. A transpedicular approach allows anterior access for decompression and debridement but insertion of a strut graft may be difficult. Hence, it is primarily indicated in patients with peridiscal lesions with neurologic deficit who do not have a significant deformity or significant bone destruction. The costotransversectomy approach and the lateral extracavitary approach allow anterior strut grafting and hence are preferred when there is compete destruction of a vertebra resulting in a significant kyphotic deformity. The lateral extracavitary approach is also useful when performing vertebral column resections for the correction of post-tubercular kyphosis. In the lumbar spine, posterior approach is primarily restricted to performing supplementary posterior instrumentation or for a TLIF-like procedure in patients with juxta-discal lesions.

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