The Journal of Bone and Joint Surgery, Vol 67, Issue 9 1405-1413, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Tuberculous spondylitis in adults
RM Lifeso, P Weaver and EH Harder
We treated 107 adults with spinal tuberculosis. The average age was 41.8
years (range, sixteen to seventy-five years). Diagnosis was difficult: bone
scans were negative in 35 per cent; gallium scans, negative in 70 per cent;
and results of tuberculin skin tests, negative in 14 per cent. Five
neurologically impaired patients had no discernible bone lesions when they
were first seen but were found to have either intradural or extradural
tuberculomas or tuberculous arachnoiditis. Our indications for a spinal
operation were neurological impairment, spinal instability, or failure of
medical management, and an operation was required in fifty-three of the 107
patients. Anterior decompression and fusion was the surgical procedure of
choice. Ninety-four per cent of neurologically impaired patients recovered
normal neurological function after anterior decompression; 79 per cent,
after non-surgical treatment; and 55 per cent, after laminectomy.
Neurological recovery and relief of pain occurred more rapidly in the
surgically treated group. Kyphosis did not worsen in any patient, whether
treated medically or surgically. There were no organisms that were
resistant to isoniazid, rifampin, or ethambutol, and there was neither
progression nor reactivation of disease after twelve months of adequate
chemotherapy.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
