Surgical Treatment of Tuberculous Spondylitis: Retrospective Analysis of Risk Factors and 15 Year Experience of Single Medical Center in South Korea

ABSTRACT

OBJECTIVE: Despite the development of society and improvement in public hygiene, the number of cases of tuberculous spondylitis (TS) has increased recently. This study was designed to analyze the risk factors and operation methods of TS. METHODS: In this medical record-based retrospective study, there were 83 cases reviewed of instances where TS was operated in between 1996 to 2010 at one hospital. In order to observe a change according to times, the authors divided patients into three groups by five years. We used Cochran's Q test to compare between the groups. RESULTS: The mean age of patients was 46.1+/-18.1 years, and 44.6% of the patients were male. The operated sites were mostly lumbar (42.2%) and thoracic (33.7%) spine. Eighteen patients (21.7%) had a history of pulmonary tuberculosis (TB), and only 15.6% had other underlying medical disorders. Between the groups, there were no statistically significant differences in age, gender, location, medical risk factors, or socioeconomic factors. The only two factors statistically significant were history of smoking and pulmonary TB. Operation methods have been changed from anterior approach to posterior approach. Visual analogue scale was improved significantly after the treatment (from 6.16 to 3.32) and postoperative satisfaction rate was 91.6%. CONCLUSION: The number of patients operated due to TS has increased, and so does primary TS without pulmonary tuberculosis. A combination of surgical operation and medical treatment of the TS tends to have more favorable outcomes.