Tuberculosis of the spine

Jain, Anil K.; Rajasekaran, Shanmuganathan

doi:10.4103/0019-5413.93671

Cited by 35 publications

(53 citation statements)

References 16 publications

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“…Spinal tuberculosis prevails in many parts of the world and is a severe orthopedic problem, usually presenting with kyphosis, neurological deficit, and even paraplegia [10,11,12] . The definitive management of Pott's disease has always been a topic of controversy.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2017

Int. J. Orthop. Sci.

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Introduction: Pott's disease or Pott's disease is a form of tuberculosis that occurs outside the lungs whereby disease is seen in the vertebrae. Tuberculosis can affect various tissues apart from the lungs including the spine, a kind of tuberculous arthritis of the inter-vertebral joints and it is usually termed as extra-pulmonary tuberculosis. The disease involving the spine is named after Percivall Pott (1714-1788), a British surgeon. The lower thoracic and upper lumbar vertebrae are the areas of the spine most often affected. Materials and methods: 12 patients with active spinal tuberculosis with severe kyphosis, neurological deficits and radiologically evident disease were included. Aim was to evaluate the efficacy and clinical outcomes of posterior surgical approach and posterior instrumentation in the management of tuberculosis of spine. Results: Total 12 patients were included 6 males and 6 females with average age being 37.2 years.3 patients had history of tuberculosis in the past. Two patients had pleural effusion; one patient had tuberculosis of the elbow. The average number of vertebra involved is 1.8 (range 1-3 vertebra). 10 cases had cold abscess with tubercular debris (wet lesion).And two cases were dry lesions. Graft consolidation and functional outcome was excellent in most of cases and good in remaining cases. Conclusion:The posterior approach to Thoraco lumbar spine has many advantages and it doesn't have complications associated with the other approaches. Our results show that single stage circumspinal decompression + anterior spinal fusion + posterior Moss-Miami instrumentation + posterior spinal fusion through posterior approach is an alternative treatment for Thoraco lumbar spinal tuberculosis. It is a minimum surgical intervention that has minimum morbidity compared to other approaches and encourages neurological recovery, good correction and prevention of progressive kyphosis.

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Section: Discussionmentioning

confidence: 99%

Untitled

2017

Int. J. Orthop. Sci.

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“…9,10 Cases with multi-and extreme drug-resistant tuberculosis make bacterial culture and antimicrobial sensitivity mandatory before initiating treatment.…”

Section: Discussionmentioning

confidence: 99%

“…1,4,6,9,11 Many of these patients are bed-bound due to paraplegia, requiring prolonged in-hospital stay and extended rehabilitation at an appropriate facility. This places an additional burden on an already strained health care system.…”

Section: Discussionmentioning

confidence: 99%

Costotransversectomy in thoracic spinal tuberculosis

Botha

2016

SA orthop. j.

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Background: The escalating global pandemic of tuberculosis infections results in 8 million new cases diagnosed each year. The thoracic and thoracolumbar spine is the most prevalent area involved in musculoskeletal tuberculosis. Deformity with associated neurological compromise, requiring extended in-patient treatment and rehabilitation, is common.Multidrug-resistant tuberculosis is prevalent and tissue samples are needed to obtain bacterial culture and sensitivity. Decompression of the spinal canal, directly or indirectly, should accelerate neurological recovery. Methods:A retrospective study was performed at Tygerberg Hospital to evaluate the efficacy of costotransversectomy in spinal thoracic tuberculosis with regard to neurological recovery and deformity. Neurological status was compared at 6 months post-operatively with the pre-surgical status. The end deformity was compared with Rajasakeran's equation.Results: Thirty patients met the inclusion criteria, with an average age of 37 years. Fifteen patients were HIV positive, and ten of them on highly active antiretroviral therapy (HAART). The average CD4 count was 235.The mean neurological status of the group was classified as Frankel C, but this improved to Frankel D at 6 months post-surgery. Initial sagittal deformity was 18.7°, which increased to 26° one year post-operatively. This was not significantly different from the 25.6° kyphosis predicted by the Rajasekaran formula. A 67% positive culture yield for TB was obtained which compared favourably to percutaneous transpedicular needle biopsies performed at the same institute which had a yield of 56%. Conclusions:Costotransversectomy is a simple procedure resulting in indirect decompression of the spinal cord, improving the microbiological diagnosis of spinal tuberculosis, and possibly leading to earlier neurological recovery, without the risk of creating further instability and greater deformity.

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“…3 The worst complications of tuberculosis of the spine are neurological deficits that may take the form of para-or tetraplegia, hemiplegia or monoplegia. 4 These neurological deficits occur in 15-42.5% of patients with spondylitis TB. 5 Spondylitis TB is usually accompanied with a deformity of the spine, which occurs in 80% cases, along with the occurrence of gibbus angulation, that is a form of structural kyphosis where one or more adjacent vertebrae become wedged.…”

Section: Introductionmentioning

confidence: 99%

Correlation between Degree of Gibbus Angulation, Neurological Deficits, and Pain in Spondylitis Tuberculosis Patients

Hadian

Prasetia

Faried

2017

IJIHS

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Objective: To analyze the correlation between the degree of angulation and neurological deficits as well as pain in spondylitis tuberculosis (TB) patients.Methods: This observational-analytic study included bivariate analysis on data collected from the medical records of patients with presented with spondylitis TB to Dr. Hasan Sadikin General Hospital, Bandung outpatient clinic from January 2014 to December 2015. The variables were the degree of gibbus angulation, neurological deficits, and pain. Results:The study showed significant positive correlation between gibbus angulation and sensory neurological deficits (r=0.375; p=0.009) and there was significant positive correlation between gibbus angulation and pain (r=0.638, p=0.000). The study showed an insignificant correlation between gibbus angulation and motoric neurological deficits (r=0.125; p=0.525). Conclusions:There is a significant correlation between the degree of gibbus angulation and pain as well as sensory neurological deficits. Meanwhile, no significant correlation is found between the degree of gibbus angulation and motoric neurological deficits.

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Tuberculosis of the spine

Cited by 35 publications

References 16 publications

Untitled

Untitled

Costotransversectomy in thoracic spinal tuberculosis

Correlation between Degree of Gibbus Angulation, Neurological Deficits, and Pain in Spondylitis Tuberculosis Patients

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