Sufficient considering tissue for histopathological examination was obtained and the clinical diagnosis of tuberculosis of spine was confirmed by pathologists in all the cases. The average operative time was 140.88 �� 20.09 minutes (range: 105�C165 minutes), average blood loss was 417.77 �� 190.90mL (range: 220�C730mL), and average hospital stay was 5.77 �� 0.97 days (range: 4�C7 days). As per Frankel’s grading, 7 patients had Grade A neurological involvement preoperatively, which improved at subsequent followups (Table 1). Table 1 Neurological improvement as per Frankel’s grading. Radiographs of the spine revealed wedge collapse with contagious involvement in all patients. Average vertebral height loss, deformity angle, and kyphotic angle initially were 0.48, 11.8��, and 24.

2��, respectively; the final values were 01, 22��, and 37��, respectively. As per CT the average percentage canal encroachment was 52.7% at initial presentation which improved to 10% at the time of final followup; it also revealed that fusion was present in 75% of the patients at their final followup. On MRI, all patients showed paradiscal and contiguous involvement of vertebrae; average vertebrae involvement per patient was 2.88 at presentation and 2.33 at the time of final followup. Paravertebral collection and subligamentous spread were seen in all patients at initial presentation, with an average vertebral extent of paravertebral soft tissue collection and subligamentous spread as 4.3 vertebrae each initially, which dropped to 2.7 and 1 vertebrae, respectively, at time of final followup.

The mean preoperative kyphosis angle in patient without (n = 6) and with (n = 3) bone graft was 25�� and 23�� and at time of final followup was 41�� and 24��, respectively. Two of the six patients without bone grafting achieved fusion at six months and another four at 12 months. Eck et al. criteria for fusion assessment were used to grade the fusion in 3 patients with bone grafting, according to which all 3 cases achieved Grade II fusion at six months and showed further improvement to Grade I at 12 months (Table 2). Table 2 Status of fusion in patients. Back pain as assessed using visual analogue scale improved from a pretreatment score of 8.3 to 2 at final followup. Functional outcome assessed as per the modified Kirkaldy-Willis criteria revealed 3 patients to have an excellent outcome, while good outcome was observed in 1 patient. The most common complication was conversion to minithoracotomy in two patients. It was due to extensive pleural adhesions leading to difficulty in graft placement in one case and bleeding during placement of portals in Dacomitinib another case. None of our cases had pneumothorax, pneumonitis, chylothorax, or Horner’s syndrome.