Tuberculosis of the lumbosacral junction. Long-term follow-up of 26 cases

Abstract

Of 37 consecutive patients suffering from tuberculosis of the lumbosacral spine, 26 were reviewed after an average follow-up of 20 years. Those presenting at under 10 years of age usually had a discharging sinus or a pointing abscess and a visible kyphosis. In older patients, low back pain was the predominant presenting symptom. Neurological involvement was uncommon. Both operative and conservative treatment had resulted in fusion but all patients treated conservatively ended up with a kyphosis associated with trunk shortening. They had a higher incidence of back pain and more complications in pregnancy. Anterior debridement and fusion with a strut graft can reduce the incidence and size of kyphosis, but is technically demanding. Treatment remains difficult and requires individual consideration.

Spinal tuberculosis with concomitant spondylolisthesis: coexisting entities or ‘cause and effect’?

“…6 Several large series have focused on tubercular lesion of the lumbosacral region (Bhojraj et al, 66 cases; Moon et al, 56 cases; Rajasekaran et al, 53 cases; Pun et al, 26 cases). [5][6][7][8] However, none of them have reported any case of spondylolisthesis either secondary to or coexisting with tuberculosis in the same patient. Pathological spondylolisthesis secondary to tuberculosis, or coexisting spondylolisthesis and spinal tuberculosis is an extremely rare occurrence.…”

“…The results of conservative treatment of tubercular spondylolisthesis with spinal braces and multidrug antitubercular chemotherapy are satisfactory and surgical stabilization is seldom needed. 2,5,6,8 …”

Operative treatment of progressive deformity in spinal tuberculosis

“…Fusion of the diseased area of the spine can be produced by non-operative treatment, but the kyphosis persists [9,10,11].…”

Tuberculosis of the Musculoskeletal System

“…49,57 Patients often present with pain, and neurologic dysfunction is uncommon. Kyphotic deformities are seen with some frequency.…”

“…While Moon et al report a relatively benign course in 56 adults treated by chemotherapy alone, 49 Pun et al found late pain and degenerative changes in more than 50% of patients, with significant kyphosis in 14 of 26 patients. 57 Compensatory lordosis in FIG. 9.…”