Published: 2017-01-14

Evaluation of implant stabilization in tubercular Spondylodiscitis: a prospective study

Sharath Kumar Maila, Akyam Lakshman Rao, Rajani Somappa Sunnadkal, Murali Krishna


Background: Stabilization in tubercular spine is very often employed for various indications. Many papers have detailed the management strategies and outcome in the management of spinal tuberculosis.  There are not many papers detailing the complications that followed stabilization in tubercular spine, which are very essential in the development of safe surgical procedures and avoiding complications. In the present study 50 patients who were stabilized for tubercular spine were followed up for a period of 2 years. Various complications encountered during this period were detailed with a possible mechanism for the same and a strategy to address such a complication.

Methods: 50 consecutively available patients who underwent a standard stabilization procedure for spinal tuberculosis and were available for follow-up for a period of 2 years were subjects of the study.  All the complications encountered in these patients during the follow-up period were noted and were managed.

Results: Mechanical failure of the implant was the most commonly encountered complication. Neurological complications included progressive neurologic deterioration, hoarseness of voice, cauda equina syndrome, foot drop. Persistent worsening of pain, DVT and pressure ulcers were the complications encountered that are not specific to a region of spine.

Conclusions: Stabilization is not without complications in tubercular spine. But with strict adherence to guidelines the complications can be minimal and are not dismal.



Tubercular spine, Implant stabilization, Complications of stabilization

Full Text:



Formicola V, Milanesi Q, Scarsini C. Evidence of spinal tuberculosis at the beginning of the fourth millennium BC from Arene Candide cave (Liguria, Italy). Int Orthop. 1987;11(4):315-22.

Bakhsh A. Medical management of spinal tuberculosis: an experience from Pakistan. Spine (Phila Pa 1976). 2010;35:E787–E791.

Oga M, Arizono T, Takasita M, Sugioka Y. Evaluation of the risk of instrumentation as a foreign body in spinal tuberculosis: Clinical and biologic study. Spine. 1993;18:1890–4.

Jain AK, Dhammi IK, Prashad B, Sinha S, Mishra P. Simultaneous anterior decompression and posterior instrumentation of the tuberculous spine using an anterolateral extrapleural approach. J Bone Joint Surg Br. 2008;90:1477–81.

Jain AK. Tuberculosis of the spine: a fresh look at an old disease. J Bone Joint Surg Br. 2010;92:905–13.

Chen WJ, Chen CH, Shih CH. Surgical treatment of tuberculosis spondylitis: 50 patients followed for 2-8 years. Acta Orthop Scand. 1995;66:137–42.

Hassan MG. Anterior plating for lower cervical spine tuberculosis. Int Orthop. 2003;27:73–7.

Jain AK. Tuberculosis of the spine: Editorial comments. Clin Orthop Relat Res. 2007;460:2–3

Quiles M, Marchisello PJ, Tsairis P. Lumbar adhesive arachnoiditis. Spine. 1978;3:45-50.

Agrawal V, Patgaonkar PR, Nagariya SP. Tuberculosis of spine. Journal of Cranovertebral Junction and Spine. 2010;2:74-85.