Minimally invasive lateral trans-psoas approach for tuberculosis of lumbar spine

Anterior, posterolateral and posterior approaches are used for managing lumbar tuberculosis. Minimally invasive methods are being used increasingly for various disorders of the spine. This report presents the utility of lateral trans-psoas approach to the lumbar spine (LS) using minimal access techniques, also known as direct lateral lumbar interbody fusion in 2 cases with tuberculosis of LS. Two patients with tuberculosis at L2-3 and L4-5 presented with back pain. Both had destruction and deformity of the vertebral body. The whole procedure comprising debridement and placement of iliac crest graft was performed using tubular retractors and was augmented by posterior fixation using percutaneous transpedicular screws. Both patients recovered well with no significant procedure related morbidity. Post-operative computed tomography scans showed appropriate position of the graft and instrumentation. At follow-up, both patients are ambulant with no progression of the deformity. Minimal access direct lateral transpsoas approach can be used for debridement and reconstruction of ventral column in tuberculous of Lumbar spine. This paper highlights the growing applications of minimal access surgery for spine