Exploring the Effectiveness of Transpedicular Fixation for Managing Thoracic and Lumbar Tuberculous Spine Disease

Background: Tuberculous spine disease, particularly in the thoracic and lumbar regions, poses a significant health challenge in Pakistan, necessitating effective surgical interventions. Transpedicular fixation has emerged as a promising treatment option, yet there is a paucity of comprehensive studies evaluating its efficacy within this demographic. Objective: The study aimed to systematically assess the effectiveness of transpedicular fixation for treating thoracic and lumbar tuberculous spine disease in Pakistan by analyzing preoperative conditions, surgical details, and postoperative outcomes. Methods: This retrospective cohort study involved 78 patients from the Neurosurgical Ward of Khyber Teaching Hospital, Peshawar, who underwent transpedicular fixation from January 2021 to December 2022. Demographics, preoperative clinical data, radiological findings, intraoperative details, and postoperative outcomes were collected. Statistical analysis was conducted using SPSS version 26, employing Chi-square and t-tests to evaluate outcome significance. Results: The patient cohort comprised 53.85% males, with a mean age of 36.3 years. The lumbar region was the most affected (45%), followed by the thoracic (38%) and thoracolumbar (17%). Postoperative outcomes indicated an improvement in radiological stability from 48.72% preoperatively to 73.08% postoperatively (p=0.001), a non-significant increase in complications (12.82% to 19.23%, p=0.231), and a slight rise in patient satisfaction (84.62% to 88.46%, p=0.453). Conclusion: Transpedicular fixation is effective in improving radiological stability and maintaining high patient satisfaction in the treatment of thoracic and lumbar tuberculous spine disease in Pakistan. The procedure's safety profile is acceptable, though the slight increase in postoperative complications warrants attention.