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Behaviour of the kyphotic angle in spinal tuberculosis
A K Jain1, P K Aggarwal, A Arora
1Department of Orthopaedics, University College of Medical Sciences and GTB Hospital, 110095 Shahdara, Delhi, India. draniljain@hotmail.com
International Orthopaedics
|June 30, 2004
Summary
Spinal tuberculosis can lead to worsening kyphotic deformity over two years. Patients treated with surgery and chemotherapy showed less progression of spinal kyphosis compared to those on chemotherapy alone.
Area of Science:
- Orthopedics
- Infectious Diseases
- Radiology
Background:
- Spinal tuberculosis (Pott's disease) is a significant cause of spinal deformity.
- Kyphosis, an excessive outward curvature of the spine, can result from vertebral destruction.
- Long-term outcomes regarding kyphotic progression in treated spinal tuberculosis require further elucidation.
Purpose of the Study:
- To evaluate the progression of spinal kyphosis in adult patients with spinal tuberculosis.
- To compare the efficacy of multi-drug chemotherapy alone versus combined antero-lateral decompression and chemotherapy in managing kyphotic deformity.
Main Methods:
- A prospective study followed 70 adult patients with spinal tuberculosis for at least 2 years.
- Group A (40 patients) received ambulant multi-drug chemotherapy.
- Group B (30 patients) with neurological complications underwent antero-lateral decompression and chemotherapy.
Main Results:
- Kyphotic deformity progressed in both groups over the 2-year follow-up period.
- Group A (chemotherapy alone) showed a mean increase in kyphotic angle of 7.4 degrees.
- Group B (surgery and chemotherapy) demonstrated a significantly lower mean increase of 0.9 degrees, indicating less progression.
Conclusions:
- Spinal tuberculosis can lead to continued kyphotic progression even after treatment.
- Antero-lateral decompression combined with chemotherapy is more effective in limiting kyphotic deformity progression than chemotherapy alone in spinal tuberculosis patients with neurological complications.