Progression of kyphosis in tuberculosis of the spine treated by anterior arthrodesis.

Rajasekaran, Shanmuganathan; Soundarapandian, Sivamurugan

doi:10.2106/00004623-198971090-00006

Cited by 229 publications

(179 citation statements)

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“…Bony fusion was seen in 18 patients at 3 months, 24 patients at 6 months and in all 28 patients by 9 months. Three stages of bone graft consolidation were observed: (1) No new bone, lytic area around the graft; (2) Callous formation but no bridging trabaculae; (3) Trabaecular continuity with no lytic areas.…”

Section: Resultsmentioning

confidence: 99%

Single stage decompression, anterior interbody fusion and posterior instrumentation for tuberculous kyphosis of the dorso-lumbar spine

2001

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Results: The mean kyphosis correction obtained was 62.5% with the mean post-operative kyphosis angle reducing to 24.1 (range 5 ± 60). At a mean follow-up of 5.8 years (4 ± 7 years) the mean kyphosis angle loss was 3.28 (range 0 ± 58). Of the 23 patients with neurological de®cit, recovery was seen in 21 cases (91.3%) while deterioration was seen in one case (4.3%). The remaining ®ve patients were neurologically intact pre-operatively. Bony fusion was seen in all cases at 9 months. One patient with subpulmonary function died post-operatively (mortality 3.5%). Conclusion:The results of our series are encouraging. However single stage decompression with fusion and kyphosis correction is a very demanding surgery and should be performed after taking into account the risks and bene®ts involved. This surgery perhaps prevents progression of neurological de®cit and recurrence of late onset paraplegia in these complex cases in developing countries. Spinal Cord (2001) 39, 429 ± 436

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Section: Resultsmentioning

confidence: 99%

Single stage decompression, anterior interbody fusion and posterior instrumentation for tuberculous kyphosis of the dorso-lumbar spine

2001

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“…Moon [22] suggests that in addition to its failure in some cases to correct the existing kyphosis, anterior arthrodesis does not prevent the increase in kyphosis angle. Rajasekaran et al [26] also reported a progression in kyphosis particularly in anterior arthrodesis at two or more levels and recommended additional stabilization methods.…”

Section: Discussionmentioning

confidence: 99%

“…Active disease can be eradicated by efficient chemotherapy [20,21,30,32]. However, chemotherapy alone or long periods of bed rest or external supports combined with chemotherapy may not be effective in the prevention of paraplegia and kyphosis [20,22,26]. The British Medical Research Council recommended that spinal tuberculosis is best treated by specialist surgeons and by chemotherapy and radical anterior intervention under appropriate conditions [20,30].…”

Section: Introductionmentioning

confidence: 99%

“…The British Medical Research Council recommended that spinal tuberculosis is best treated by specialist surgeons and by chemotherapy and radical anterior intervention under appropriate conditions [20,30]. The kyphotic correction and cord decompression achieved by radical anterior intervention as described by Hodgson and Stock may be under risk with the collapses, breaks or insufficiency problems that may result resorption in the grafts used [12,22,26,29]. The reinforcement of correction performed in kyphotic deformity with posterior or anterior instrumentation prevents the collapse or breakdown of the graft, decreases pseudoarthrosis rate, and allows early ambulation and rehabilitation [1,2,6,9,12,15,16,22,25,26,29,31,33].…”

Section: Introductionmentioning

confidence: 99%

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The results of simultaneous posterior–anterior–posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosis

et al. 2010

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We retrospectively studied the cases with tuberculous spondylitis of thoracolumbar region with two or more levels of involvement that underwent posterior instrumentation and fusion and anterior fusion with titanium mesh following anterior decompression using simultaneous successive posterior-anterior-posterior surgery. Among all patients with tuberculous spondylitis accompanied by medium or severe kyphosis, 20 patients who underwent simultaneous successive decompression, fusion and instrumentation with posterior-anterior-posterior surgery between 1999 and 2004 were included in the study. Patients were evaluated for fusion formation and neurological and functional status. Kyphosis angles were measured at early and long-term follow-up. Antituberculosis chemotherapy was initiated in all patients and continued for 9 months; initially as quadruple therapy for 3 months, and then as triple therapy. Average follow-up period was 52.7 months (range 37-94). Solid fusion was achieved in all patients. All patients returned to their previous occupation; 75% (15 subjects) with mild pain or no pain and 15% (3 subjects) with major limitations. There were 11 patients with neurological deficit, 9 of these achieved complete neurological recoveries. Regarding kyphosis angle, an average 35.1°correction (84.8%) was obtained in postoperative period (p \ 0.001) and there was no significant correction loss during the follow-up period (p \ 0.05). There were no grafts or instrumentation-related stabilization problems. In subjects with tuberculous spondylitis with involvements at two or more levels accompanied by medium and severe kyphosis, decompression, fusion and instrumentation by simultaneous successive posterior-anterior-posterior surgery is an effective and safe management method for effective kyphosis correction with high fusion rates.

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“…For decades the gold standard has been an anterior debridement and in-situ fusion [9,10,13,16]. However, an increasing number of studies advocate a combination of posterior stabilisation and anterior debridement and interbody fusion.…”

Section: Discussionmentioning

confidence: 99%

Titanium cages in the surgical treatment of severe vertebral osteomyelitis

Liljenqvist

Lerner

Bullmann

et al. 2003

European Spine Journal

134

123

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Progression of kyphosis in tuberculosis of the spine treated by anterior arthrodesis.

Cited by 229 publications

References 0 publications

Single stage decompression, anterior interbody fusion and posterior instrumentation for tuberculous kyphosis of the dorso-lumbar spine

Single stage decompression, anterior interbody fusion and posterior instrumentation for tuberculous kyphosis of the dorso-lumbar spine

The results of simultaneous posterior–anterior–posterior surgery in multilevel tuberculosis spondylitis associated with severe kyphosis

Titanium cages in the surgical treatment of severe vertebral osteomyelitis

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