Journal List > J Korean Orthop Assoc > v.28(5) > 1113836

Kim, Ko, Lim, Seo, Choi, and Suh: Surgical Treatment of Paraplegia in Spinal Tuberculosis

Abstract

Tuberculous spondylitis account for from one third to one half of the bone and joint tuberculosis. Paraplegia is one of the .most disabling and distressing complication of spinal tuberculosis. In 1779, Percivall Pott pointed out that the cause of paraplegia is destruction of the vertebral bodies and recommened surgical drainage as the treatment. Since then, many operative treatment have been described and developed, and after the development of satisfactory chemotherapeutic agent, more aggressive surgery was attempted, including costotransversectomy with bone grafting and radical debridement and bone grafting as popularized by Hodgson. Hodgson recommended early surgery to prevent the development of dural invasion by the infection, resulting in irreversible paralysis. Particularly, for the impending paraplegia in spinal tuberculosis, early decompression and drainage is necessary to prevent further complication. The authors treated the impending paraplegia as early as passible. And the surgical method was curettage and anterior interbody fusion with autogenous tricortical bone graft. The authors evaluated radiologically and clinically the 26 patients with impending paraplegia admitted to Inje university Paik Hospital from Jan. 1979 to Jan. 1991 and the results are following. 1, The prevalent age ranged from 21 to 40 years old. 2. Antituberculosis chemotherapy prior to operation was usually given for the period of 2 weeks. 3. Average follow up period was 5 years and 3 months. 4. Most common involving area was thoracic vertebrae. 5. Preoperative kyphotic angle was 33.2 degree, postoperative angle was 24.2 degree, but the angle was increased during follow up period. 6. Complete neurologic recovery was 70%, partial recovery was 30%.

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