ORIGINAL ARTICLES   

Journal of Neurosurgical Sciences 1998 December;42(4):213-9

Copyright © 1998 EDIZIONI MINERVA MEDICA

language: English

Tuberculous spondylitis: a retrospective study on a series of 12 patients operated on in a 25-year period

Rychlicki F. ¹, Messori A. ¹, Recchioni M. A. ¹, Morici D. ², Dobran M. ¹, Pauri F. ¹, Ducati A. ¹, Papo I. ¹

¹ Clinic of Neurosurgery, University of Ancona, Italy; ² Department of Orthopaedics, University of Ancona, Italy

Background. The inci­dence of tuber­cu­lous spon­dy­litis, which had ­declined stead­i­ly for over 40 years in our coun­tries, start­ed increas­ing again in the eight­ies, par­allel­ing the resur­gence of pul­mo­nary tuber­cu­lo­sis. Therefore it has ­become a mat­ter of dis­cus­sion in con­tem­po­rary lit­er­a­ture, ­because it can be a diag­nos­tic chal­lenge and, in spite of its ­severe neu­ro­log­i­cal com­pli­ca­tions, it is a poten­tial­ly cur­able ill­ness.
Methods. In this ret­ro­spec­tive study the ­authors ­report their expe­ri­ence con­cern­ing 12 ­patients oper­at­ed on in a 25-year peri­od ­because of seri­ous cord com­pres­sion from tho­rac­ic (9 cases) and cer­vi­cal (1 case) tuber­cu­lous spon­dy­litis or from tho­rac­ic tuber­cu­lar epi­du­ral ­lesion (2 cases). Surgical tech­niques were select­ed on the basis of the cause of cord com­pres­sion. Fusion with autol­o­gous bone and metal­lic oste­o­syn­the­sis was per­formed in the cer­vi­cal case (1986); no other ­patient ­received spi­nal instru­men­ta­tion, and this can be ­explained with the con­sid­er­a­tion that all but one cases of Pott’s par­a­ple­gia were treat­ed in the years 1968-1977. In all of these cases ­fusion was ­achieved by means of plas­ter jack­ets and pro­longed bed rest. Prolonged chem­o­ther­a­py was system­at­i­cal­ly admin­is­tered.
Results. Follow-up data col­lect­ed in 1995 show good and long-last­ing ­results.
Conclusions. They con­clude that sur­gi­cal treat­ment is ­required in case of cord com­pres­sion and ­results can be excel­lent even in pres­ence of ­severe neu­ro­log­i­cal impair­ment; spi­nal instru­men­ta­tion avail­able in our era ­should be now con­sid­ered in order to make reha­bil­i­ta­tion ear­li­er and mor­pho­log­ic ­results more sat­is­fac­to­ry.