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Kyphosis secondary to infectious disease
Clinical Orthopaedics and Related Research
|October 1, 1977
Summary
Spinal infections, particularly tuberculosis, cause progressive kyphosis and can lead to cord compression. Early diagnosis and treatment, including drug therapy and anterior fusion, are crucial for managing spinal tuberculosis and its associated defects.
Area of Science:
- Orthopedics
- Infectious Diseases
- Spinal Surgery
Background:
- Spinal infections, often staphylococcal or tuberculous, typically affect the vertebral body, leading to kyphosis.
- Non-tuberculous infections are often diagnosed late and can cause cord involvement.
- Tuberculous spinal infection constitutes 59% of orthopedic tuberculosis, invariably involving vertebral bodies and causing progressive deformity.
Purpose of the Study:
- To highlight the diagnostic challenges and treatment considerations for spinal infections, with a focus on tuberculosis.
- To outline the key defects associated with spinal tuberculosis and the principles of effective treatment.
Main Methods:
- Review of non-tuberculous and tuberculous spinal infections, emphasizing clinical presentation and diagnostic delays.
- Discussion of treatment strategies including open exploration, stabilization, graft procedures, drug therapy, and surgical correction for established deformities.
Main Results:
- Tuberculous spinal infection is progressive, causing inevitable kyphosis and potential cord compression, with T-10 being most associated with cord compression.
- Non-tuberculous infections may present with less severe destruction and kyphosis compared to neglected tuberculous cases.
- Established tuberculous kyphosis is a fixed deformity requiring staged operations and gradual correction, often with Halo-pelvic apparatus.
Conclusions:
- Effective treatment for spinal tuberculosis requires addressing mechanical instability, chronic infection, cord compression, growth disturbance, and impaired lung function.
- Drug therapy and anterior fusion are cornerstones for treating spinal tuberculosis.
- For established tuberculous kyphosis, multi-stage operations with gradual correction using the Halo-pelvic apparatus offer the best available treatment.