The goal of treatment of tuberculous spondylitis is eradication of infection and maintenance of the stability of spinal column with prevention or correction of deformity. But the correction of kyphotic deformity and its maintenance is a difficult
problem in tuberculous spondylitis after anterior debridement and fusion with tricortical bone graft. Authors reviewed 140 cases of tuberculous spondylitis treated at Seoul Paik hospital from Jan. 1980 to Jan. 1990 to evaluate the statistical
analylsis.
Among them, 65 cases were followed more than 2 years after the anterior currettage and interbody fusion. The kyphotic angle after correction were measured during the follow up period in 65 cases of anterior interbody fusion.
@ES The results were as follows;
@EN 1. The prevalent age was 3rd and 4th decade and the ratio of the male and female was not significant.
2. The most frequently involved site was the lumbar spine(39%) and the average number of affected vertebra was 2.31.
3. The other tuberculous lesions combind with the spondylitis were found in 69 cases of 61 patients and pulmonary tuberculosis was the most common (68%).
4. The paraplegia or paraparesis was frequently developed in the thoracic lesions and appeared in 19% of all patients.
5. The kyphosis was corrected 89.2% immediately after operation but it was decreased to 78.5% after 3 months after operation and 70.8% at 6 months, and 60% at 2 years.
6. The mean increment of the kyphotic angles between postoperation and last follow-up (2 years) was 13.4 degree in children and 7.4 degree in adults. The cases with more than 10 degree increase of kyphotic angle were 56% of children and 24% of
adults.
7. There were no correlation between the numbers of involved vertebrae and the loss of correction.
8. The causes of the increased kyphotic angle were 3 cases of graft absorption. 3 cases of nonunion and 3 cases of growth imbalance between anterior and posterior part of the vertebrae in children, and 6 cases of graft absorption, 3 cases of
graft
fracture & displacement, 2 cases of nonunion and 1 case of recurrence in adults.
9. The loss of correction mostly occurred during the first 6 months after the operation and these were due to displacement or fracture of grafted bone, absorption of grafted bone and reactivation of inflammation, etc.
10. The adequate chemotherapy, good quality of bone graft and adequate external support are necessary to prevent the postoperative loss of correction of kyphosis in tuberculous spondylitis.
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