ABSTRACT
Some experience in treating 144 patients with tuberculous spondylitis is presented. The cervical, thoracic, and lumbar parts of the spine were affected in 12, 83, and 49 patients, respectively. Medical and surgical treatment was performed in 82 (57%) and 62 (43%) patients, respectively. The medical treatment included the use of antituberculous drugs, pathogenetic exposures, and an orthopedic regimen. The surgical treatment was a stage of multimodality therapy in 62 patients and it involved the radical elimination of a specific inflammation focus, followed by bone defect replacement and vertebral ceramic implant stabilization. The long-term results were studied in the periods of 2 to 10 years. All the patients were found to have a formed osseous block: exacerbations and recurrences being absent.
Subject(s)
Spondylitis/therapy , Tuberculosis, Spinal/therapy , Adolescent , Adult , Aged , Antitubercular Agents/therapeutic use , Female , Humans , Male , Middle Aged , Spondylitis/drug therapy , Spondylitis/surgery , Treatment Outcome , Tuberculosis, Spinal/drug therapy , Tuberculosis, Spinal/surgeryABSTRACT
The use of osseous grafts in the treatment of tuberculous spondylitis is associated with substantial shortcomings, requiring a long-term bedside regimen, followed by fixation of the spine with a rigid corset. The application of ceramic implants allowed one to attack several tasks: to provide primary stabilization of the vertebral segment, to exclude corset fixation, to reduce a postoperative period and surgical traumatism by refusing to take an autograft. Forty nine operations were performed in patients aged 23-65 years. In the early postoperative period neurological disorders completely disappeared in 7 patients, the remaining has significant positive changes. Complete osteoceramic adhesion occurred 2-4 months later. Following 2 patients, 26 patients were stricken off the disability register. The remaining patients continued to be disabled (7 and 16 patients had disability groups 2 and 3, respectively) due to significant contaminant diseases.
