Spinal Tuberculosis Research Articles

Pott's disease and multiple myeloma in the bone marrow: A rare coincidence

Pott’s disease also known as tuberculosis (TB) spondylitis is the most dangerous form of musculoskeletal TB. It is associated with neurological deficits. Multiple myeloma (MM) is characterised by bone degradation and suppression of the immune system. It often presents itself as bone pain and anaemia. Coexistence of Pott’s disease and TB is a rare occurrence. However, we present a patient with persistent back pain and anaemia, who was initially diagnosed with TB. Despite treatment with anti-TB medication for six months, he developed bone pains, lower limb numbness, and pallor. On radiographic, laboratory, and pathologic investigations, MM with Pott’s disease was diagnosed. This case points out the fact that MM may coincide with active or recurrent TB. Due to the similarity of their clinical symptoms, one of them may be ignored, and this will lead to serious complications for the patient.

Atypical Spinal Tuberculosis of Upper Thoracic Spine: A Rare Case Report

Background: Tuberculous infection is one of the most common pulmonary infection in developing countries, including Indonesia. Spinal tuberculosis is one of the most common extra¬pulmonary tuberculosis manifestation, accounting for 5% of all extrapulmonary spread, and 50% of all osteoarticular involvement. The aim of this study is to evaluate and how diagnosis and treatment to prevent over or under-diagnosis and explain about excellent management without any late complication further. Case Presentation: A 20-year-old male with a history of weakness of both of his leg for 20 days prior to admission. From these examinations, patient was then diagnosed with pathological fracture 2nd thoracic vertebral body suspected due to atypical spinal tuberculosis. Patient was then undergone surgical debridement, decompression, stabilization and fusion. Results: Patient was then undergone surgical debridement, decompression stabilization fusion. During the exposure at level C6 through Th4, no abscess was found. Transpedicular debridement at level Th2 was then done after the insertion of pedicle screws at level C6-Th1 and Th3-Th4, and again no abscess was present, however, a granulomatous mass was present on the location of 2nd thoracic vertebral body, located on the anterior right side of the spinal cord outside the dura mater. Conclusion: Atypical presentation of spinal tuberculosis with the sole clinical manifestation of neurological deficit below affected level. The definitive treatment such as surgical debridement, stabilization and fusion must be consider. Keywords: spinal, infection, tuberculosis, young patient. Correspondence: I Gusti Lanang Ngurah Agung Artha Wiguna. Division of Spine, Department of Orthopaedic & Traumatology, Prof. I.G.N.G Ngoerah Hospital, Faculty of Medicine, Udayana University, Bali, Indonesia. Email:lanangwiguna20021979@gmail.com. Mobile: 0811388859. Indonesian Journal of Medicine (2022), 07(03): 289-297 https://doi.org/10.26911/theijmed.2022.07.03.05

Oncological and infectious destructive lesions of the cervical spine in children (literature review)

Objective: to analyze the current literature on tumors and osteomyelitis of the cervical spine in children. Design: a systematic literature review. Material and methods. Рublications were selected from the follow-ing scientific databases Pubmed, eLibrary.ru, Cochrane Library for the period from 2010 to 2021. The final sam-ple included 70 articles containing information about 187 children. Demographic data, clinical manifestations of diseases, features of diagnosis verification, surgical treatment and treatment results were analyzed. Re-sults. Тhe average age of patients in the sample was 9.4 years. The average duration of the diagnostic pause was 8.7 months. The most common complaint was neck pain; the most common etiological causes were tu-berculous spondylitis and benign tumors — 50% and 33%, respectively. Surgical treatment was performed in 81% of cases; the average duration of postoperative follow-up was 47.6 months. Conclusion. Destructive lesions of the cervical spine in children are rare. Sum-marizing these published articles allows to get a more complete picture of their clinical manifestations and treatment options.

Halo-external fixator frame-assisted correction to treat severe kyphotic deformity in children younger than 4 years old

BACKGROUND: Severe kyphotic deformity in young children may have devastating outcomes when neglected. Halo-pelvic traction has been shown to be very effective as part of the treatment for severe kyphosis, but little is known about application of this technique in very young individuals. The aim of this case series was to provide novel insights into the surgical technique associated with halo-external fixator frame (HEFF) treatment for severe spinal deformity in patients younger than 4 years old, along with the associated radiologic outcomes and complications METHODS: Clinical and demographic characteristics including the duration in the HEFF, HEFF-associated change in kyphosis angle (KA) and final KA following definitive surgery were extracted from medical records RESULTS: Five female patients with a mean age of 36 months (range 30-44) were included. Three patients had thoracic spinal tuberculosis (mean KA 82°), one had lumbar spinal tuberculosis (KA 42°) and one had iatrogenic post-laminectomy cervical kyphosis (type 1 neurofibromatosis)(KA 112°). The HEFF was applied for a mean of six weeks and resulted in a mean thoracic deformity correction of 29° (38%), a lumbar correction of 23° (55%) and cervical correction of 47° (42%). Definitive surgery resulted in a further mean overall deformity correction of 28, and patients had a satisfactory KA angle (23° lordosis to 31° kyphosis) at the last follow-up. HEFF-associated complications included pin-site infection, pneumonia and frame dislodgement CONCLUSION: HEFF appears to be an effective method for correcting severe kyphotic spinal deformity in very young patients where other options are limited. It allows for independent mobilisation and can provide for spinal stabilisation while awaiting bony healing after definitive surgery. However, healthcare providers should be aware of the potential dangers of HEFF hardware, such as difficulty in establishing an airway due to the fixed position of the neck Level of evidence: Level 4

Thoracic tuberculosis misdiagnosed as lumbar compression fracture and treated with percutaneous kyphoplasty (PKP): a case report and literature review

Thoracolumbar tuberculosis is a common clinical disease. In this study, a 63 years old female patient had back pain after physical work. X-ray examination showed that the 8th thoracic vertebra was compressed. MR showed that the signal of the 8th thoracic vertebra was abnormal, and T2 showed an obviously high signal. Then, she was misdiagnosed as compression fracture of the thoracic spine at first diagnosis and treated with percutaneous balloon kyphoplasty (PKP) and the pain was gradually aggravated 3 months after the operation; then, lower extremity neurological symptoms began to appear. After that, she was finally diagnosed with tuberculosis of the thoracic spine and received surgery again and then the symptoms were ameliorated significantly, and the muscle strength of both lower limbs recovered. For patients with thoracolumbar compression fractures, we should fully understand the disease history of the disease and perform a detailed examination. The tuberculosis and even tumors should be considered to avoid misdiagnosis.

Posterolateral migration of complete vertebral body in neglected tuberculosis of the spine

Posterolateral migration of complete vertebral body in neglected tuberculosis of the spine

Study of functional outcome of surgical treatment of tuberculosis of spine

Study of functional outcome of surgical treatment of tuberculosis of spine

Posterolateral approach to the thoracic spine for spinal tuberculosis: A Technical Note and an Analysis of Results

Surgical pathologies in the thoracic spine are principally located anteriorly within the vertebral body resulting in vertebral body destruction, kyphotic deformity, and anterior or anterolateral compression of the spinal cord. Adequate decompression of the neural elements and vertebral body reconstruction requires access to the anterior spinal column. The posterolateral approach through a posterior midline incision allows circumferential spinal cord decompression, anterior column reconstruction, correction of thoracic kyphosis, and posterior spinal stabilization to be safely performed through a single incision, at a single sitting with excellent outcomes.

Retrospective Study of Magnetic Resonance Imaging (MRI) Findings in Pott’s Spine

Introduction: Skeletal tuberculosis accounts for approximately two percent of all infected tuberculosis (TB). Magnetic resonance imaging (MRI) due to its inherent soft tissue contrast is a very good tool to diagnose the condition and look for its extent and deformities. This study aims to study the MRI findings in a patient with diagnosed case of spinal tuberculosis. Methods: The study was carried out in a referral diagnostic imaging center in western Nepal. All MRI studies of the spine performed in a patient with diagnosed spinal tuberculosis during the study period were included in the study. Patients lacking microbiological or pathological diagnoses of spinal tuberculosis were excluded from the study. Results: A total of 70 patients were included in the study. The mean age of the patients was 45.6 ± 16.8 years. All patients in the study had a spondylodiscitis pattern of involvement. Single intervertebral disc and adjacent vertebrae were involved in 85.7% and multiple contiguous vertebrae and IV discs were involved in 14.3% of cases. Gibbus deformity was seen in 17.1% of cases. Pre/paravertebral and Epidural collections were seen in 95.7% and 72.9% of patients respectively, whereas psoas abscess was seen in 28.6% of patients. Cord compression with myelopathy was seen in 8.6% of patients. Involvement of posterior elements was seen in 27.1% of patients. Conclusion: MRI is an excellent tool to see the extent, deformity, and abscess in spinal tuberculosis. Most patients with tuberculosis present late with collections and deformities.

Tubercular Mycotic Aortic Aneurysm: Complication of Tubercular Spondylodiscitis due to Treatment Default

AbstractWe have reported rare case of tubercular aortic aneurysm which has developed as complication of spinal tuberculosis. Imaging of patient is available prior to starting of antitubercular treatment which showed vertebral tuberculosis with absence of aortic aneurysm. However, patient defaulted on treatment after taking antitubercular chemotherapy only for 2 months. Patient again reported after 14 months with chest pain. At this stage, imaging showed progression of spinal tuberculosis with development of pseudoaneurysm in adjacent descending thoracic aorta. This contiguous spread of tuberculosis from spine to aorta may have been prevented if patient had completed complete course of antitubercular therapy with regular follow-ups. Patient of spinal tuberculosis need to be counselled and informed regarding its various complications, so that they remain adhered to antitubercular chemotherapy and timely follow-ups to prevent complications.

Relationship between magnetic resonance imaging findings and prognosis of intracranial tuberculosis.

Intracranial tuberculosis (TB) is an intracranial infection caused by Mycobacterium tuberculosis. Magnetic resonance imaging (MRI), in particular enhanced MRI scan, has the ability to detect characteristic lesions of tuberculous meningitis or cerebral parenchymal TB. To analyze the relationship between MRI findings and prognosis of patients with intracranial TB. In this retrospective study, a total of 60 patients were confirmed with intracranial TB in the hospital from May 2019 to December 2020. All enrolled patients underwent TB-related laboratory examinations, cranial MRI, and contrast-enhanced MRI. Laboratory tests were analyzed and the relationship between clinical prognosis and cranial MRI features was evaluated. Of the 60 patients, 28 (46.67%) had disseminated TB complications, 20 (36.67%) had secondary TB complications, and the remaining 10 (16.66%) had lymphatic TB or spinal TB complications. Of the patients, 25 had good short-term prognosis and 35 had poor short-term prognosis; 44 patients had good long-term prognosis and 16 had poor long-term prognosis. The incidence of cerebral parenchymal tuberculomas on enhanced MRI was significantly higher in the group with good prognosis compared to that in the group with poor prognosis (P < 0.05). Logistic analysis suggested that hydrocephalus (odds ratio [OR] = 0.057, 95% confidence interval [CI] = 0.003-0.444; P = 0.018) and cistern involvement (OR = 0.100, 95% CI = 0.011-0.581; P = 0.017) were independent risk factors for poor short-term prognosis. MRI can display the pathological changes of intracranial TB in detail; hydrocephalus and cistern involvement were independent risk factors for poor short-term prognosis.

Efficacy of Short Term Intermittent Chemotherapy in DOTS Regimen in Extra Spinal Tuberculosis

Noncompliance is one of the major issues with the treatment of tuberculosis (TB), which can lead to treatment failure. A short-course of chemotherapy as recommended by World Health Organization under the umbrella term of Directly Observed Treatment Short Course (DOTS) therapy seems to be effective. The main aim in present study was done to evaluate the efficacy of short term intermittent chemotherapy in DOTS regimen in patients with extra spinal osteoarticular TB. The present prospective study was conducted in the Department of Ortho &amp; Spine Surgery, National Institute of Traumatology &amp; Orthopaedic Rehabilitation (NITOR), Dhaka, Bangladesh over a period of one year between January 2018 to February 2019. 21 patients included in our Study. All the patients were given the DOTS regime as recommended by WHO and followed up at intervals of one month during the treatment for assessing the clinical improvement and compliance of the patient. The results in present study, there were 85.71% males and 14.29% were females. 42.86% were students followed by the labourer (28.57%). Hip (47.62%) was the most commonly involved joint followed by short bones of hand and foot (19.5%). All (100%) patients had an elevated ESR at the time of presentation. Eighty percent patients had shown increase in weight at the end of 6 month of treatment. All patients of extra spinal osteoarticular TB showed improvement. Treatment was found sufficient for 80% of the patients. In 20% cases treatment duration was extended. In discussion the Short term intermittent chemotherapy in DOTS regimen was optimum for the treatment of extra spinal osteoarticular TB and was associated with good compliance.

Surgical Outcomes of Transpedicular Decompression with or without Global Reconstruction in Thoracic/Thoracolumbar Pott's Spine: A 7-Year Institutional Retrospective Study.

Study DesignRetrospective case-control study.PurposeThis study aimed to analyze the radiological and clinical outcomes of transpedicular decompression in spinal tuberculosis (or Pott’s spine) with and without anterior reconstruction using polyetheretherketone (PEEK) or mesh cage.Overview of LiteratureThe outcomes of transpedicular decompression with and without global reconstruction in Pott’s spine are insufficiently investigated. Additionally, the use of PEEK cages in Pott’s spine has remained unestablished.MethodsUsing the hospital records and imaging database obtained from January 2014 to January 2020, this study retrospectively analyzed patients who underwent surgery for Pott’s spine and met the eligibility criteria.ResultsThis study included 230 patients with a mean±standard deviation age of 47.7±18.1 years (109 males, 121 females). The Visual Analog Scale score, Oswestry Disability Index, and Cobb angle were significantly improved in these patients (p<0.001). Patients who underwent anterior reconstruction had a greater correction in Cobb angle postoperatively (p=0.042) but also had a greater blood loss (p=0.04). During the follow-up, they experienced a significant loss of correction compared with those who only underwent transpedicular decompression (p=0.026). Nevertheless, patients who underwent anterior reconstruction using mesh/PEEK cages showed no significance difference in the clinical or radiological outcomes.ConclusionsTranspedicular decompression used in the surgical management of Pott’s spine showed favorable clinical and radiological outcomes. The additional use of anterior reconstruction obtained equivalent clinical outcomes but resulted in excessive blood loss. Meanwhile, the use of mesh/PEEK cage for anterior reconstruction did not affect the clinical and radiological outcomes.

Analysis of Clinical Characteristics of 556 Spinal Tuberculosis Patients in Two Tertiary Teaching Hospitals in Guangxi Province.

Spinal tuberculosis (STB), which accounts for half of musculoskeletal tuberculosis, is among the leading causes of extrapulmonary tuberculosis. Guangxi Province, located in southern China, is among the most severely affected provinces in China. In this study, we collected and analyzed data from 2 Class-A tertiary teaching hospitals in Nanning City, Guangxi Province, from 2011 to 2019, with the aim of providing reference points for the prevention, diagnosis, treatment, and prognosis analysis of STB, using the epidemiological characteristics of 556 STB cases. Our results revealed that males had a slightly higher incidence (50.17%) compared to females (49.83%), with 64.93% of cases falling between the ages of 18 and 45 years. Cases from rural communities accounted for 63.49% of the reviewed cases. The average time between onset of symptoms and hospitalization was 18.0 months (range: 1 day-220 months). The most commonly reported symptoms were lower back pain (78.60%), radicular pain (51.98%), and systemic toxemia (43.53%). Additionally, 53.98% of the reviewed cases had varying degrees of neurological impairment. The main pathological lesion locations were the lumbar spine (43.53%) and thoracic spine (32.55%). Among them, 72.66% of cases involved at least 2 vertebral segments, and 62.77% of cases presented with paravertebral abscesses. Among the cases reviewed, 90.65% underwent antituberculosis chemotherapy prior to surgery. Following treatment, the cure rate was 78.41%, while 3.78% of patients had postoperative relapse. There were cases of concomitant illnesses among the cases reviewed, 40.65% of patients also had pulmonary tuberculosis, 15.29% had hepatitis B, 13.30% had diabetes, and 7.91% had hypertension. Our results still demonstrate that spinal tuberculosis remains a serious public health problem in Guangxi Province. Thus, preventive measures should be directed towards rural residents with comorbidities such as the elderly and diabetic.

Figurative aspects suggestive of infectious diseases in the ceramic pots of the pre-Columbian Moche culture. Analysis of the ceramics collection in the Larco Museum of Lima, Peru.

The historical-medical and anthropological studies, regarding Mesoamerica and South America, have been mainly focused on the great empires (Inca, Atzec, Maya), while other civilizations have been less investigated and only recently are gaining interest. In general, the paleopathological research provides interesting data to know the type of nutrition and the general environmental conditions as well as to point out some ritual mutilation practices, which were relatively frequent in the pre-Columbian cultures. A lot of civilizations flourished in the South America before the arrival of the Spanish Conquistadores in the new world. In the last years it is progressively increasing the interest for the study of the Moche culture as well as for a deeper knowledge of pathocenosis of infectious diseases in the Moche society. Human infectious diseases are known to have a frequent animal origin, in particular from domesticated species, although the species domesticated in the pre-Columbian era were a small number. The purpose of our paper has been to examine the archeological findings suggestive of infectious diseases in artistic ceramic pots, dating back to the Moche period. We examined the iconography of ceramic pots belonging to the collection of the Larco Museum in Lima and reproducing body signs suggestive of infectious diseases. We identified 8 handworks with very interesting features by a medical point of view. In these handworks there are signs and lesions possibly associated with infectious diseases: risus sardonicus, orbital edema, facial nerve palsy, dorsal kyphosis, face and skin lesions. These features are compatible with some infectious diseases, including: syphilis, Bartonella bacilliformis, leishmaniasis, Pott's disease and Chagas disease. A wide discussion about these handworks is provided.

Diagnosis of spinal tuberculosis in an Asian patient with unexplained chronic back pain.

Diagnosis of spinal tuberculosis in an Asian patient with unexplained chronic back pain.

Comparative diagnostic value of GeneXpert MTB/RIF, PCR targeting IS6110 and culture for the diagnosis of spinal tuberculosis

Introduction Spinal tuberculosis is an extra-pulmonary tuberculosis infection caused by Mycobacterium tuberculosis (MTB) which affects the vertebrae. Culture test is the «gold standard» diagnostic method, but it takes a long time. PCR is a method of a shorter time than the culture test, so it can be an alternative diagnostic method for MTB. Materials and Methods This study is a cross-sectional study. The data were analyzed with diagnostic tests on patients with suspected spinal tuberculosis who performed surgery in Hasan Sadikin Hospital in Bandung. Clinical examinations and diagnostic examinations were done in 40 patients and surgery was performed to obtain samples from the spinal cord and the infected tissue. GeneXpert, PCR targeting IS6110 and culture tests were performed. The research was conducted at the Department of Orthopaedics and Traumatology and the Clinical Pathology Laboratory of FK UNPAD/RSHS from September 2019 to September 2020. Results GeneXpert assay compared with culture tests as the standard diagnostic method showed sensitivity of 96.67 %; specificity of 90.00 %; positive predictive value 96.67 %; and a negative predictive value of 90.00 %, with an accuracy of 95.00 %. The PCR targeting IS6110 against culture showed that the sensitivity of MTB bacterial infection was 93.33 %, the specificity was 80.00 %, the positive predictive value was 93.33 %, the negative predictive value was 80.00 %, and the accuracy was 90.00 %. Conclusion This study concluded that the GeneXpert MTB/RIF RT-PCR assay has a high sensitivity, specificity, and accuracy compared to PCR targeting IS6110 in examining tissue samples in patients with spinal TB.

Сравнение основных факторов риска формирования сепсиса у пациентов с неспецифическим остеомиелитом позвоночника и туберкулезным спондилитом

Background Chronic osteomyelitis is characterized by changes in bone structure of different extent and severity that are poorly defined. The objective was to determine the incidence of sepsis in patients with non-specific osteomyelitis of the spine (NOS) and tuberculous spondylitis (TS), and compare the main risk factors contributing to the occurrence. Material and methods Treatment was produced for 82 patients with verified sepsis that accounted for 8.6 % of all patients operated for infectious spondylitis (IS). Patients were diagnosed with NOS (n = 48, Group 1) and TS (n = 34, Group 2). Microflora in the blood was detected in half (n = 39, 47.5 %) of the patients with procalcitonin test performed in all cases. Results IS patients were diagnosed with chronic pulmonary diseases (45/58.0 %), renal diseases (32/39.0%), chronic stomach and duodenal diseases (23/28.0 %), viral hepatitis (18/21.9 %), cardiovascular diseases (23/28.0 %), diabetes mellitus (12/14.6 %), etc. Factors contributing to the development of sepsis in TS patients were chronic pulmonary diseases (p = 0.024, χ2 = 7.132), liver cirrhosis (p = 0.036, χ2 = 6.458) and HIV (p = 0.035, χ2 = 6.158). Discussion Risk factors for septic conditions in IS patients included age over 70 years, severe neurological deficit, hypoalbuminemia, cachexia (BMI &lt; 17 kg/m2), obesity (BMI &gt; 35 kg/m2), HIV and severe comorbidities (ASA 3 or ASA 4). The favorable outcome of the disease occurred due to early detection of sepsis based on SOFA score and timely initiated pathogenetic treatment.

Surgical Management of Spinal Tuberculosis - A Retrospective Observational Study from a Tertiary Care Center in Karnataka.

Context:Tuberculosis (TB) is a common infectious disorder in developing countries. A significant load of patients with extrapulmonary TB are diagnosed in our institute, mostly involving the spine.Aim:We aimed to present our experience in the surgical management of spinal TB.Setting and Design:This was a retrospective observational study.Materials and Methods:Seventy patients (year 2016–2018) who underwent surgical management with minimum of 1-year follow-up (17 patients lost during follow-up) were graded as per the American Spinal Injury Association (ASIA) grading system for neurological deficits. All were surgically treated with laminectomy and epidural abscess drainage/transpedicular debridement of granulation with/without spinal stabilization. Thoracic and lumbar cases were managed by posterior approach; among them, 12 patients who had no significant cord compression and good ASIA grade with facet involvement (requiring fusion) underwent minimally invasive pedicle screw fixation. Cervical cases were managed mostly by anterior approach. All patients received Anti-tubercular treatment (ATT) post operatively as per protocol postoperatively, following which magnetic resonance imaging (MRI) spine was done.Statistical Analysis:Data were analyzed using SPSS software version 18.0 (SPSS Inc. Released in 2009. PASW Statistics for Windows, version 18.0. Chicago, IL, USA: SPSS Inc.). The continuous variables were analyzed using descriptive statistics using mean and standard deviation.Results:The average age was 42.5 years. The most common location was thoracic (28 patients), followed by lumbar (20 patients), cervical (16 patients), and thoracolumbar (6 patients). Twenty patients had epidural abscess with cord compression. All patients who presented within 4 weeks of onset of symptoms showed a statistically significant improvement postsurgery. Sixteen patients with epidural abscess had good neurological recovery immediately after surgery (ASIA B to ASIA D/E). Four patients with epidural abscess with late presentation remained ASIA A after surgery. All patients had good fusion rates (follow-up X-ray) at 1 year. After ATT course completion, all patients had complete eradication of disease (MRI spine).Conclusion:Surgical treatment for spinal TB, if performed early (within 4 weeks) with good decompression, results in satisfactory clinical outcome with early improvement in the neurological deficits. Posterior approach to the spine with decompression and fixation gives good results, and minimally invasive procedures further help lessen muscle dissection, less pain, and early mobilization.

Comparative analysis of long-term outcome of anterior reconstruction in thoracic tuberculosis by direct anterior approach versus posterior approach

Study Design:Retrospective study.Aim:To retrospectively evaluate and compare the long-term outcome of anterior vertebral body reconstruction in tuberculosis (TB) of the dorsal spine by direct anterior-versus-posterior approach.Materials and Methods:A total of 127 patients operated by posterior approach, 118 by anterior for TB-thoracic spine with at least 1-year follow-up were included and retrospectively analyzed. Patients were assessed clinically, radiologically and data regarding age, sex, levels involved, surgical approach, operative time, blood loss, neurological recovery using Frankel grade, pre- and post-operative kyphosis, % correction of kyphosis, time for fusion, fusion grading using Bridwell criteria, % loss of correction, mobilization time and complications if any were collected, analyzed, compared in anterior-v/s-posterior approaches.Results:The mean age in anterior-approach was 36.03 and 39.83 years in posterior. Mean operative time in anterior-approach was 6.11 and 5 h in posterior. Mean blood loss of 1.6 L in anterior approach and 1.11 L in posterior. Mean preoperative kyphosis angle in posterior-approach was 34.803°and 11.286° (P < 0.001) at 3 months postopandtotal correction of 67.216%. Mean preoperative kyphosis angle in anterior-approach was 41.154° and 9.498° at 3 months postopandtotal correction of 77.467% (P < 0.001). Mean loss of correction at 1 year was 4.186°in posterior-approach and 6.184°in anterior. The mean time for fusion was 4.69 months in anterior-approach while 6.34 months in posterior as per Bridwell criteria. Meantime for mobilization in posterior-approach was 1.18 and 2.51 weeks in anterior. Significant improvement in neurology was seen in patients operated by either approach, slightly better in anterior. Complications were more in posterior-approach.Conclusions:Anterior-approach allows for thorough debridement, neural decompression, better anterior column reconstruction, and deformity correction under direct vision than posterior. Direct cord visualization while correcting kyphosis reduces the chances of neurological complications significantly. Both approaches have unique advantages and limitations. Though the posterior approach is easy to master, results shown by the anterior cannot be overseen. To conclude, better functional outcome and significantly better kyphosis correction are seen with anterior-approach, which are strong pointers favoring it.