SURGICAL TREATMENT OF TUBERCULOUS SPONDYLITIS
Journal Title: Journal of Turkish Spinal Surgery - Year 2016, Vol 27, Issue 2
Abstract
Purpose: There is consensus on medical management of tuberculous spondylitis (TBS); however, literature is quite divided on surgical management of TBS. We aimed to illustrate surgical indications and treatment modalities for TBS in the management of selected patients. Materials and Methods: A total of 19 patients with different vertebral tuberculosis were treated with surgical intervention. There were 10 male and 9 female patients, mean age was 48±18.1 years and mean follow-up time was 59.9±27.7 months. There was avarage 1.2±0.5 disc and 2.2±0.5 vertebral body involvement. Results: 15 cases were surgically debrided through anterior approach, 4 were surgically debrided through posterior approach, 1 patient treated with anterior screw fixation and 17 patients treated with posterior pedicle screw fixations. Mean corpectomy level was 1.7±1.2 and mean fusion level was 6.8±3.8. Postoperatively, 4 patients had suffered from complications which were significantly higher in cases with more intervertebral disc involvement (p=0.005), with more vertebral body involvement (p=0.033), with more number of corpectomies (p=0.003) and with more fusion levels (p=0.023). Conclusions: Debridement should be performed in cases of neurological impairment, multilevel involvement or severe abscess formation. Posterior instrumentation should be added to prevent anterior implant failure in multilevel involvement.
Authors and Affiliations
Ibrahim KAYA, Necdet SAĞLAM, Murat YILMAZ, Sevda UĞRAŞ, Akin UĞRAŞ, Fatih DİKİCİ
Keywords
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