Conservative treatment of tuberculous spondylitis: a long-term follow-up study.
A retrospective follow-up study was performed on 40 patients, in which tuberculous spondylitis was treated conservatively between 1969 and 1985 with orthotic supports for an average of 16 months (range, 10-30 months) and with anti-tuberculous agents. All had persistent back pain, but none had neurological deficits. The mean follow-up period was 17 years (range, 10-26 years). Diagnosis was confirmed histopathologically. The spinal segments involved ranged from T5 to L5. The kyphotic angle was calculated according to Cobb. At final follow-up, 22 patients were pain free, 11 had occasional pain, 6 complained of pain in the morning, and 1 had chronic pain and needed frequent analgesics. Solid bony union was found in 75% of patients. The kyphotic deformity occurred in the thoracic spine with a mean angle of 20 degrees (range, 13-28 degrees) and in the lumbar spine with a mean angle 12 degrees (range, 5-26 degrees). The long-term follow-up of conservative treatment showed only slightly increased kyphosis. Conservative treatment is an alternative to surgical intervention in cases with kyphosis < 35 degrees.
Wimmer
C
C
Department of Orthopaedic Surgery, University of Innsbruck, Austria.
Ogon
M
M
Sterzinger
W
W
Landauer
F
F
Stöckl
B
B
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000453:epidemiology / Q000382:microbiology / Q000628:therapy; D017116:Low Back Pain / Q000188:drug therapy / Q000209:etiology; D008159:Lumbar Vertebrae / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009989:Orthotic Devices; D012189:Retrospective Studies; D012307:Risk Factors; D013130:Spinal Stenosis / Q000150:complications / Q000382:microbiology / Q000628:therapy; D013166:Spondylitis / Q000150:complications / Q000382:microbiology* / Q000628:therapy*; D013168:Spondylolisthesis / Q000150:complications / Q000382:microbiology / Q000628:therapy; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000628:therapy*
D000700:Analgesics