Changes of Kyphotic Angle Following Operative Treatment of Tuberculous Spondylitis / 대한척추외과학회지

ABSTRACT

STUDY DESIGN: Thirty-seven patients with spinal tuberculosis were evaluated according to surgical method. OBJECTIVES: To evaluate the effectiveness of posterior spinal instrumentation in the surgical treatment of patient with tuberculous spondylitis. SUMMARY OF LITERATURE REVIEWS There are many debates about the effectiveness of posterior spinal instrumentation combined with anterior interbody fusion in tuberculous spondylitis. MATERIALS AND METHODS: From January 1995 to June 2000, 37 patients were divided into two groups depending on their use of posterior spinal instrumentation. Group I consist of thirteen patients who were treated with conventional anterior corpectomy and anterior interbody fusion using autogenous strut bone graft. Group II was composed of twenty-four patients who were treated with conventional anterior corpectomy and anterior interbody fusion combined with posterior spinal instrumentation. Changes of corrected kyphotic angle and complication were measured using pre-, post-operative and follow-up radiographs and chart review. RESULTS: In group I, six cases (46.2%) showed loss of corrected kyphotic angle. Of these six cases, five cases had initial kyphotic angle of more than 20 dgree and three cases had involvement of two or more vertebrae. All six cases had thoracic or thoracolumbar involvement. Comparing two groups, maintaining corrected kyphotic angle and low complication rates were obtained in group II during follow-up period. The change of deformity as followed. In thoracic area, the mean kyphotic angle of 26.5 dgree was reduced to 18 dgree postoperatively, At the most recent follow-up, the mean kyphotic angle was 31.5 dgree in group I, a loss of correction of 13.5 dgree . In group II, the mean kyphotic angle was corrected from 27 dgrees to 13.5 dgree after surgery. At the most recent follow-up, the mean kyphotic angle was 17.5 dgrees, a loss of correction of 4 dgree . CONCLUSION: Posterior spinal instrumentation combined with conventional anterior corpectomy and anterior interbody fusion were found to be effective for preventing loss of kyphotic angle and for maintaining stable bone fusion in patients with mean