Question

Surgical management of Pott’s spine (TB).

Hint:

Surgical management is typically reserved for cases with neurological impairment or severe deformity, with a focus on relieving pressure and stabilizing the spine.

Answer 1

Step 1: Indications for Surgery in Pott’s Spine:
Surgical intervention is required in certain cases where medical management alone is insufficient or if there are complications. Indications for surgery include: 1. Neurological Deficits: If there is progressive neurological impairment due to spinal cord compression or abscess formation.
2. Spinal Deformities: Severe kyphosis or spinal instability that affects function or causes pain.
3. Failure of Medical Therapy: If there is inadequate response to anti-TB medications after an appropriate duration of therapy.
4. Abscess Drainage: In cases of paraspinal or epidural abscess formation.
Step 2: Surgical Procedures:
1. Debridement and Drainage: Surgical removal of necrotic tissue and drainage of abscesses may be necessary in cases with large paraspinal or epidural abscesses.
2. Spinal Fusion: In cases of spinal instability or severe deformities, spinal fusion may be performed to stabilize the affected vertebrae.
3. Decompression: If there is significant compression of the spinal cord, decompression surgery may be performed to relieve pressure and prevent further neurological damage.
4. Postoperative Care: After surgery, immobilization with a brace or external support is usually required to ensure proper healing and prevent further complications.