ABSTRACT

Recently, cases with tuberculosis were seen increasingly in our country. Consequently, spinal tuberculosis was also increased. In the current study, we evaluated that development of deformity and neurological recovery of patients with spinal tuberculosis diagnosed by clinical, radiological and laboratory findings.

The 41 patients (20 female, 21 male) with spinal tuberculosis; their mean age was 29 years (range 18-80 years) and follow-up duration was average 40 months (range 1-36 months) were retrospectively reviewed. Four cases were treated conservatively with antituberculosis medication plus ambulatuar treatment with plaster of paris jacket for 6 months. Thirty-seven cases were treated with surgically; 32 of them were taken antituberculosis drug therapy together with anterior radical debridman with anterior fusion and 5 patients were treated with posterior fusion plus instrumantation in addition to previous therapy.

Neurological status of the patients at pre- and post-treatment were considered based on Frankel neurological staging while kyphotic deformities were evaluated by using measurement of local kyphosis angle and sagittal indexes.

Although 29 of 41 patients had neurological deficit before the treatment; 26 of them (89.6%) were completely improved whereas 3 patients (10.4%) were seen improvement only one grade according to Frankel staging at the last follow-up visit. Baseline sagittal indexes were mean 19±5° in the patients treated conservatively whereas it was 23±3° at last follow-up. Improvement on sagittal index was 71% in patients who were treated with only anterior intervention while it was 83% in patients who were performed anterior plus posterior combined intervention. None of the patients had complication needed additional surgical procedure and recurrence.

The results showed that effectiveness and type of treatment procedures which was applied in addition to chemotherapy spinal tuberculosis were associated with age of patient, amount of involved vertebra and abscess presence which can be caused neurological deficit.