Introduction: Infective Tubercular Spondylodiscitis primarily affects the anterior vertebral column. If left untreated, this condition can lead to vertebral collapse, kyphotic deformity, and neurological complications. Treatment options typically include anterior or posterior approaches for decompression and correction. Generally, posterior methods are associated with fewer complications. This study aims to evaluate the effectiveness of the posterior approach for decompression and reconstruction in cases of spinal tuberculosis.

Methodology: A total of 24 patients (14 males and 10 females) with thoracolumbar tubercular spondylodiscitis characterised by anterior collapse were included in the study, with an average age of 33.5 years. The mean kyphotic angle was 63.5 degrees, and the average vertebral body loss was 1.9. All patients underwent surgical management through the posterior approach decompression, debridement, anterior reconstruction using a mesh cage and bone graft, and posterior instrumentation. Follow-ups assessed clinical, radiological, haematological, and neurological outcomes at six-week intervals for four months, followed by monthly assessments. Neurological recovery was evaluated using the Frankel scoring system, while functional outcomes were measured using the Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI).

Results: Patients were monitored for a minimum of 27 months. The VAS scores showed significant improvement, decreasing from 8.2 preoperatively to 1.4 at follow-up (p < 0.001). The mean correction of kyphosis was 32.3 degrees (p < 0.05). Additionally, the ODI scores improved from 59.5 to 22 (p < 0.05), indicating notable neurological recovery (p < 0.05). One patient experienced implant loosening and infection, which necessitated the removal of the implant. Three patients had transient neurological deficits.

Conclusion: The posterior approach is a safe and effective method for treating spinal tuberculosis. It allows for decompression and anterior reconstruction in a single stage, with stable spinal fixation supporting quicker recovery.