Outcome Analysis of Subaxial Cervical Spine Tuberculosis Operated by the Anterior Approach: A Single-Center Experience

Introduction Though spinal tuberculosis has a predilection for the dorsal and lumbar spine, a high percentage of morbidity and mortality is associated with cervical tuberculosis. Cervical tuberculosis accounts for about 10% of cases, with the major concerns being quadriparesis/quadriplegia and kyphotic deformity. Herein we describe our experience with the use of anterior instrumentation with titanium implants in 46 patients with subaxial tuberculosis.

Materials and Methods Included in the study were a total of 46 patients with subaxial cervical (C3-C7) and upper dorsal (D1-D3) tuberculosis who underwent operations with anterior debridement, decompression, bone grafting, and anterior instrumentation by a single surgeon at our institute between January 2007 and December 2014. A review of the demographic data, medical records, and x-rays before and after surgery and at subsequent follow-ups was performed retrospectively from the departmental database.

Results Neurological involvement in the postoperative period was seen in 29 of the 30 patients, 26 of whom showed complete neurological recovery. The Cobb angle at presentation ranged from 2°–58° of kyphosis with an average kyphosis of 15.4°. The average lordosis after surgery was found to be 17.5° (ie, a mean correction of 32.9°).

Conclusions Anterior instrumentation of subaxial cervical tuberculosis with titanium implants provides good correction of kyphosis and provides reasonable neurologic recovery in patients and ensures a long-lasting functional outcome.

Level of evidence 4.