title: Surgical outcome of 2-stage (posterior and anterior) surgical treatment using spinal instrumentation for tuberculous spondylitis.
abstract: METHODS
  A prospective study on the clinical outcomes in patients with tuberculous spondylitis treated by a 2-stage operation (posterior and anterior) using posterior spinal instrumentation.
  
  
  OBJECTIVE
  To evaluate the clinical outcomes of the 2-stage surgical treatment (first stage: placement of posterior instrumentation and second stage: anterior debridement and bone grafting) for tuberculous spondylitis.
  
  
  BACKGROUND
  There have been few reports describing the effects of 2-stage surgical treatment for tuberculous spondylitis.
  
  
  METHODS
  Ten patients (5 men and 5 women) with tuberculous spondylitis were treated by 2-stage operations. Age at the initial operation was 64.6+/-14.8 years (average+/-SD) (range: 47 to 83 y). The clinical outcomes were evaluated before and after the surgery in terms of hematologic examination, pain level, and neurologic status. Bone fusion and changes in sagittal alignment were examined radiographically.
  
  
  RESULTS
  All patients showed suppression of infection, bony fusion, relief of pain, and recovery of neurologic function. No significant changes were observed in kyphosis angle at the final follow-up. There were no incidences of severe complications or recurrence.
  
  
  CONCLUSIONS
  Our results showed that posterior and anterior 2-stage surgical treatment for tuberculous spondylitis is a viable surgical option for cases in which conservative treatment has failed. However, the changes in sagittal alignment showed that this strategy provides limited kyphosis correction.
authors.affiliation: Department of Orthopaedic Surgery, Gifu University Graduate School of Medicine, Gifu, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hirakawa
authors.forename: Kei
authors.initials: K
authors.lastname: Miyamoto
authors.forename: Takahiro
authors.initials: T
authors.lastname: Masuda
authors.forename: Shoji
authors.initials: S
authors.lastname: Fukuta
authors.forename: Hideo
authors.initials: H
authors.lastname: Hosoe
authors.forename: Nobuki
authors.initials: N
authors.lastname: Iinuma
authors.forename: Chizuo
authors.initials: C
authors.lastname: Iwai
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Nishimoto
authors.forename: Katsuji
authors.initials: K
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000995:Antitubercular Agents / Q000627:therapeutic use; D001416:Back Pain / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D016025:Bone Transplantation; D005260:Female; D006801:Humans; D016268:Internal Fixators; D007738:Kyphosis / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D011859:Radiography; D019651:Plastic Surgery Procedures; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
chemical_list: D000995:Antitubercular Agents