Surgical Treatment of Tuberculous Spondylitis

ABSTRACT

Tuberculous spondylitis develops at 5 percents of patients with systemic tuberculosis. Clinical findings of tuberculous spondylitis are back pain, paraparesis, kyphosis, and sensory disturbance. The aims of treatment are eradication of the infection, prevention of neurologic complication and spinal deformity. The authors reviewed ten cases of tuberculous spondylitis from 1992 to 1995. Nine patients had vertebral body involvements and seven had neurologic complications. Sites of involvement were thoracic(five), lumbosacral(two), and multiple levels(thoracic/lumbar, three). Tuberculous spondylitis involving multiple levels or posterior column were misdiagnosed as spinal tumor. Operative approaches were anterior approach(six), posterior approach(three), and both(one). The procedures of operation comprised of drainage of abscess, debridement of sequestered bone, decompression of spinal cord, and stabilization of the spine for correction of deformity. All patients had good neurologic outcome by way of drainage, decompression, and stabilization procedure. Thus we concluded that aggressive management should be considered when treating the patients with tuberculous spondylitis.