Costotransversectomy without instrumentation for extensive thoracic spondylosdiscitis with paraspinal abscess

Abstract

Background: Costotransversectomy without instrumentation an effective treatment in extensive thoracic Spondylodiscitis with Paraspinal Abscess Costotransversectomy without instrumentation is done to drain pus and relief cord compression where instrumentation is not visible due to extensive spondylodiscitis of the thoracic spine. Methods: Five patients, 3 male and 2 female, with wide spread thoracic spondylodiscitis underwent costotransversectomy without instrumentation in various Hospitals in Nairobi, Kenya. Their clinical outcomes in terms of neurological recovery, progression of kyphotic deformity, and Satisfaction with the surgery were reviewed.Results: Five patients, 3 male and 2 female were operated on between 2007 and 2013 and followed up for an average period of 10 months (range 6-36 months). All patients had been started on AntiTB therapy prior to surgery. All the patients with neurological deficits improved neurologically, the average kyphotic deformity progression was 8 degrees on subsequent follow up, 4 rated the overall satisfaction of the surgery as excellent, one rated it as good. Conclusion: Though the numbers are small, the study shows that uninstrumented drainage of Paraspinal abscess is an effective method of treatment extensive thoracic spondylodiscitis with paraspinal abscess and has no risk of progression of thoracic deformity. The procedure can also be safely done in a level 5 hospital as no instrumentation is necessary.