Bipul Borthakur

Pott's spine corresponds to fifty percent cases of skeletal tuberculosis. There is consensus for instrumentation and mobilization of patients with neurological deficit, whereas there is paucity of literature for cases without neurological deficit, while adhering to middle path regime. Severe pain because of instability make the patient's life miserable for mobilization and nursing care, more so in a nuclear family undergoing in-house treatment. Braces are also not sufficient to address this problem. Today spinal instrumentation is routine surgery in trauma, which can be extended for this category of patients to provide stability for early mobility with the principle of “movement is life and life is movement”. In this study 11 cases of Pott's spine without neurological deficit were included. Severe pain restricted their mobility, even after continuing 3 to 4 weeks of anti-tubercular chemotherapy and were subjected for in-situ pedicle screw fixation. Pre and post-operative pain assessed by VAS score. Post operative stability provided feeling of wellbeing and confidence which helped early mobilization and better nursing care. Mean VAS scores were in pre-operative period = 8.45, at the end of first week post-operative period = 3.36, at three months = 1.45 and at six months = 1. Mean time of walking with orthosis was 3.27 weeks. Spinal instrumentation in Pott's spine with severe pain provide effective relief and better quality of life in terms of nursing care and early mobilization, and essentially helps in prevention of deformity.