The goal in the treatment of spinal tuberculosis is to eradicate the active infection. To provide stability for the spine, and to arrest or correct the kyphosis. However among these, the residual deformity in the lumbar and lumbosacral spines has
been
an issue compared with that of the thoracic spine. Therefore this study was performed to access the residual kyphos angle in the area after the conservative treatment.
The subjects consisted of 50 regularly examined patients(13 children and 37 adults) having active tuberculosis who had ambulatory treatment from 1982 to 1993. Triple chemotherapy for 18 months(isoniazid. Ethambutol. And rifampicin) were used in
adults,
and PAS was used in children instead of ethambutal. Kyphosis angle was measured at each observation time. The children had a mean initial involvement of 1.7 vertebral bodies. Compared with 1.4 in the adults. Twelve had no body height loss except
the
disc involvement. Paravertebral abscess was aspirated or drained when it became subcutaneous and very large.
All had a favorable response to chemotherapy without neurological complication. The elevated ESR became normal within 3 to 6 months. The 23 patients had new involvement of the adjacent bodies within 18 months of treatment, though the kyphosis did
not
increase. Abscess disappeared in from 3 to 12 months. And the sinuses disappeared by 24 months. At 18 months the lesions became inactive in all, and bony fusion was evident in 12 patients(24%) at 18 months and in 19 patients (38%) at 36 months.
The
mean
internal kyphosis angle at pre-medication. 18 and 36 months in children and adults were 14.7°, 21.9°24.2°and 10.6°, 14.8°15.9°respectively. It is reconfirmed that the chemotherapy was effective in curing the tuberculosis and also preventing
the
progress of kyphosis. Radical surgery should be reserved for the exceptional cases.
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