Especially for elders, the gravity is difficult to be tolerated and the risks of wedging changes in fracture vertebra body, leading edge lowering and kyphos
are significantly higher after the removal of internal fixation, which can severely affect the long-term efficacy of surgery.
Table 1: Kumar's classification of Tuberculous paraplegia Grade Clinical features 1 NEGLIGIBLE Unaware of neural deficit, Plantar extensor/ Ankle clonus 2 MILD Walk with support 3 MODERATE Non-ambulatory, Paralysis in extention, sensory loss <50% 4 SEVERE 3+ paralysis in flexion/sensory loss>50%/ Sphincters involved Table 2 : Kumar's Clinico Radiological Classification Stage Features Usual duration 1 Pre-destructive Straightening, spasm, <3 mo hyperemia in scinti 2 Early-destructive Diminished space 2-4 mo paradiscal erosion Knuckle <10 3 Mild kyphos
2-3 verte k:10-30 3-9 mo 4 Moderate kyphos
>3 verte K:30-60 6-24 mo Severe kyphos
>3 verte K:>60 >2 years