The Results of the Surgical Treatment using Posterior Spinal instrumentation for Tuberculous Spondylitis

Chung, Yung Khee; Kim, Seok Woo; Han, Hyun Min; Lee, Eung Joo; Choi, Soo Joong; Chang, Jun Dong

Abstract

STUDY DESIGN: Twenty-nine patients with spinal tuberculousis were evaluated according to the surgical treatment methods using posterior spinal instrumentation and conventional anterior excision and interbody fusion methods without posterior spinal instrumentation.
OBJECTIVE
To confirm the effectiveness of the surgical treatment methods using posterior spinal instrumentation (combined with anterior radical excision and anterior interbody fusion ) in tuberculous spondylitis. SUMMARY OF BACKGROUND DATA: Relatively good results(maintaining corrected kyphotic angle , short fusion time, rapid rehabilitation etc.)were obtained in posterior spinal instrumetnation group, especially at thoracic and thoracolumbar spine, but no specific benefits of posterior instrumentation at low lumbar spine during follow-up period.
METHODS
Twenty-nine patients with tuberculous spondylitis were divided into two groups depending on their use of posterior spinal instrument in surgical treatment methods ; one group consisted of 18 cases which were treated by anterior radical excision of involved body and anterior interbody fusion with posterior spinal instrumentation(Group I), and the other groups consisted of 11 cases which were treated by anterior radical excision of involved body and anterior interbody fusion(Group II). Change of corrected kyphotic angle according to the level of lesion, number of involved body and complications were measured using pre-, post-operative, and follow-up radiographs and chart review.
RESULTS
Comparing the two groups, relatively short fusion time, less kyphotic angle loss, and low complication rates were obtained in posterior spinal instrumentation group(Group I) during the follow up period, especilally, at thoracic and thoracolumbar spine. However, there were no significant postoperative and follow-up results in both groups at low lumbar spine.
CONCLUSIONS
Tuberculous spondylitis can be treated, and correction can be maintained with anterior radical excision of involved body and anterior interbody fusion with posterior spinal instrumentation during follow up period.