Koch’s spine prevalence and its management modalities: A prospective study of 25 cases

Abstract

Background: A characteristic destructive form of the koch's spine constitutes half of the all musculoskeletal tuberculosis. The root cause of increased incidence in even developed countries described its molecular genetic association. It is of no doubt where overpopulation and overcrowding in developing countries the disease itself is a challenge to healthcare and a burden on incumbent Government. Methodology: We studied 25 patients of koch's spine with various level of vertebral segments involvement with altered neurology and clinical presentations with cold abscesses, 2 or more vertebral collapse, kyphotic deformity, contiguous segment involvement in adult populations. All patients underwent surgery according to level of involvement. Evaluation done with ODI questionnaires. Results: Upper middle socioeconomical patients were of 72%. 2 patients had cervival koch's (8%), 6 patients had dorsal spine (24%), 8 patients had D-L spine (32%) while 9 patients had lumbar spine koch's. Patients with stage II paraplegia was 1(16.67%) while stage III paraplegia were 5(83.33%). 20 patients were treated surgically via posterior approach, 3 patients via antero-lateral approach and 2 patients of cervical spine were treated via anterior approach. Irrespective of approach, 24 patients have excellent outcome. Majority of patients recovered around a year. 3 patients (12%) had Odi Score between 61-80 while 22 patients (88%) had score between 81-100. Conclusion: Predominantly koch's spine affects dorsolumbar region of spinal column confer good result with operative intervention with strict AKT regime in developing countries with a close watch of recurrence and relapse.