Preliminary Report of Instrumentation in Tuberculous Lumbosacral Spine
The aims of spinal tuberculosis treatment are to eradicate the disease, to prevent the development of paraplegia and kyphotic deformity, to manage the existing deformity and neurological deficit, to allow early ambulation and to return the patient back to daily life. Methods for the treatment of tub...
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| Format: | Article |
| Language: | English |
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Malaysian Orthopaedic Association
2014-11-01
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| Series: | Malaysian Orthopaedic Journal |
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| Online Access: | http://www.morthoj.org/2014/v8n3/tuberculous-lumbosacral-spine.pdf |
| _version_ | 1818902625551122432 |
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| author | T Zin-Naing |
| author_facet | T Zin-Naing |
| author_sort | T Zin-Naing |
| collection | DOAJ |
| description | The aims of spinal tuberculosis treatment are to eradicate the disease, to prevent the development of paraplegia and kyphotic deformity, to manage the existing deformity and neurological deficit, to allow early ambulation and to return the patient back to daily life. Methods for the treatment of tuberculosis of vertebra are still controversial. Conservative treatment includes medical therapy as well as external supports and surgery is indicated for deformity of spine, severe pain, or neurological compromise conditions. Most
cases in our country were late presentations with disc space already infected, and after débridement there was a large gap needing bone graft to enhance bony fusion and anterior column support. Although the spine was infected, instrumentation posed no additional hazard in terms of tuberculous discitis. Oga et al. reported that M. tuberculosis has low adhesion capability and forms only a few microcolonies surrounded by a biofilm. Moon et al. stated that interbody fusion performed with classical anterior
radical surgery per se was ineffective in the correction of kyphosis and did not prevent the increase in kyphosis angle. The present study focuses on collected clinical and radiographic outcomes in ten patients who underwent Posterior Lumbar Interbody Fusion (PLIF) for tuberculous lumbosacral spine. All the cases had instability with kyphotic deformity or loss of lordosis. Clinical outcomes were measured by Visual Analogue Scale (VAS), modified MacNab Criteria, and radiographic outcomes (segmental
kyphotic angle and total lumbar lordotic, TLL, angle) on follow-up to six months. The mean VAS back scores showed decrease, and kyphotic angles and lordotic angles improved. Three cases had excellent results, six good and one fair using the modified MacNab criteria. |
| first_indexed | 2024-12-19T20:38:38Z |
| format | Article |
| id | doaj.art-23374b30a2a948c4a3133179ad7e6116 |
| institution | Directory Open Access Journal |
| issn | 1985-2533 |
| language | English |
| last_indexed | 2024-12-19T20:38:38Z |
| publishDate | 2014-11-01 |
| publisher | Malaysian Orthopaedic Association |
| record_format | Article |
| series | Malaysian Orthopaedic Journal |
| spelling | doaj.art-23374b30a2a948c4a3133179ad7e61162022-12-21T20:06:28ZengMalaysian Orthopaedic AssociationMalaysian Orthopaedic Journal1985-25332014-11-01831521http://dx.doi.org/10.5704/MOJ.1411.004Preliminary Report of Instrumentation in Tuberculous Lumbosacral SpineT Zin-Naing0MCRSThe aims of spinal tuberculosis treatment are to eradicate the disease, to prevent the development of paraplegia and kyphotic deformity, to manage the existing deformity and neurological deficit, to allow early ambulation and to return the patient back to daily life. Methods for the treatment of tuberculosis of vertebra are still controversial. Conservative treatment includes medical therapy as well as external supports and surgery is indicated for deformity of spine, severe pain, or neurological compromise conditions. Most cases in our country were late presentations with disc space already infected, and after débridement there was a large gap needing bone graft to enhance bony fusion and anterior column support. Although the spine was infected, instrumentation posed no additional hazard in terms of tuberculous discitis. Oga et al. reported that M. tuberculosis has low adhesion capability and forms only a few microcolonies surrounded by a biofilm. Moon et al. stated that interbody fusion performed with classical anterior radical surgery per se was ineffective in the correction of kyphosis and did not prevent the increase in kyphosis angle. The present study focuses on collected clinical and radiographic outcomes in ten patients who underwent Posterior Lumbar Interbody Fusion (PLIF) for tuberculous lumbosacral spine. All the cases had instability with kyphotic deformity or loss of lordosis. Clinical outcomes were measured by Visual Analogue Scale (VAS), modified MacNab Criteria, and radiographic outcomes (segmental kyphotic angle and total lumbar lordotic, TLL, angle) on follow-up to six months. The mean VAS back scores showed decrease, and kyphotic angles and lordotic angles improved. Three cases had excellent results, six good and one fair using the modified MacNab criteria.http://www.morthoj.org/2014/v8n3/tuberculous-lumbosacral-spine.pdfSpinal tuberculosisPosterior Lumbar Interbody FusionVisual Analogue ScaleMacNab criteria |
| spellingShingle | T Zin-Naing Preliminary Report of Instrumentation in Tuberculous Lumbosacral Spine Malaysian Orthopaedic Journal Spinal tuberculosis Posterior Lumbar Interbody Fusion Visual Analogue Scale MacNab criteria |
| title | Preliminary Report of Instrumentation in Tuberculous Lumbosacral Spine |
| title_full | Preliminary Report of Instrumentation in Tuberculous Lumbosacral Spine |
| title_fullStr | Preliminary Report of Instrumentation in Tuberculous Lumbosacral Spine |
| title_full_unstemmed | Preliminary Report of Instrumentation in Tuberculous Lumbosacral Spine |
| title_short | Preliminary Report of Instrumentation in Tuberculous Lumbosacral Spine |
| title_sort | preliminary report of instrumentation in tuberculous lumbosacral spine |
| topic | Spinal tuberculosis Posterior Lumbar Interbody Fusion Visual Analogue Scale MacNab criteria |
| url | http://www.morthoj.org/2014/v8n3/tuberculous-lumbosacral-spine.pdf |
| work_keys_str_mv | AT tzinnaing preliminaryreportofinstrumentationintuberculouslumbosacralspine |