The use of antituberculous chemotherapy and the recently developed operative procedure have resulted in great progress in the radical focal curettage and anterior fusion in the treatment of the tuberculous spine.
Among 248 cases of tuberculosis of the spine who were admitted to our department since 1957 the anterior spinal fusion were done on 77 cases; 6 cases on the cervical, 13 on the dorsal and 58 on the lumber spine.
Following has been observed from the study of 77 cases of anterior fusion.
1) The duration of the postoperative cast immobilization is four months in average.
2) The inadequate preoperative antituberculous chemotherapy does not necessarily constitute an absolute contraindication for the procedure even in the patients with lesion in other organs, unless the general condition of the patient is very poor. The postoperative chemotherapy, however, is imperative in all cases and should be continued at least for the period of one year.
3) No death is observed in this series, but several complications following surgical procedure are encountered, which are preventable and not serious.
4) Direct approach and evacuation of the destroyed materials as much as possible and anterior interbody fusion appear to be the treatment of choice in most cases of the tuberculosis of the spine, when the hospital is well facilitated and the sugeon efficient.
|