OUTCOME OF PAIN FOLLOWING POSTERIOR DECOMPRESSION AND STABILIZATION FOR THORACOLUMBAR CARIES SPINE

Abstract

Background: Spinal tuberculosis (TB), particularly affecting the thoracolumbar region (caries spine), is a significant health issue, especially in high-prevalence areas like Southeast Asia. While posterior decompression and stabilization is a common surgical approach, quantifying its effectiveness specifically regarding pain relief requires further investigation in local populations.

Objective: To determine the pain outcomes following posterior decompression and stabilization in patients treated for thoracolumbar caries spine.

Methods: This Prospective Observational Study will be conducted at the Department of Neurosurgery Unit I, Punjab Institute of Neurosciences, Lahore, over six months. A sample of 97 patients (calculated based on an expected postoperative mean VAS of 1.07±0.25 with 95% confidence and 5% precision) aged 18-60 years, diagnosed clinically and radiologically (MRI) with thoracolumbar caries spine and undergoing posterior decompression and stabilization, will be recruited using non-probability consecutive sampling. Patients with spinal tumors, congenital anomalies, or multisegmental TB will be excluded. The primary outcome measure is the VAS pain score recorded preoperatively and at a three-month postoperative follow-up. Data analysis will involve descriptive statistics (mean±SD for continuous variables, frequency/percentages for categorical) using SPSS v.27.0. Stratification by age, gender, disease duration, and level of involvement will be performed, with t-tests applied post-stratification (p ≤ 0.05 considered significant).

Results: The study anticipates a statistically significant reduction in the mean VAS pain score at the three-month postoperative follow-up compared to preoperative scores. Analysis will quantify the improvement in pain following the surgical intervention across different patient subgroups.

Conclusion: Posterior decompression and stabilization is expected to be an effective procedure for significantly reducing pain in patients with thoracolumbar caries spine. The findings will help quantify the extent of pain relief and support this surgical approach in managing spinal TB, potentially improving patient outcomes in this prevalent condition.