FUNCTIONAL AND RADIOLOGICAL OUTCOMES IN PATIENTS WITH SPONDYLITIS TUBERCULOSIS AND KYPHOTIC DEFORMITY TREATED USING A TWO-STAGE CORRECTION PROCEDURE: A CASE SERIES

Ifran Saleh, Auliya Akbar

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

Abstract

Kyphotic deformity is a devastating complication of spondylitis tuberculosis as it can progress to more severe complications, such as cardiopulmonary dysfunction and nerve compression symptoms. Surgical correction is as important as local infection control itself (through debridement and abscess drainage). There are several approaches for spondylitis tuberculosis with kyphotic deformity, and all are based on the patient’s condition and other local considerations, such as hospital and national health policies. This report aims to provide information on the clinical and radiological outcomes after two-stage treatment for kyphotic deformity in patients with spondylitis tuberculosis. We present four cases of kyphotic deformity in patients with spondylitis tuberculosis who underwent two-stage surgery at Cipto Mangunkusumo National Hospital, Jakarta, Indonesia. All patients were female, with a mean age of 37.5 years. The mean follow-up period was 45 months. One patient had a lumbar lesion with loss of lordosis (less than 20° lordosis), and the remaining three had thoracic lesions with a kyphotic angle more than 45°. All patients underwent a two-stage surgery involving initial debridement, kyphotic correction, posterior stabilization, and fusion, followed by anterior fusion with a titanium cage and bone graft. The surgical outcomes were evaluated by comparing the preoperative and postoperative Oswestry Disability Index (ODI) scores and kyphotic angles. After surgery, all patients had good outcomes with reductions in the ODI score and kyphotic angle. The mean ODI score reduced from 20 preoperatively to 5 postoperatively. Additionally, the kyphotic angle reduced from 90° preoperatively to 22° postoperatively (after the second stage). Our two-stage procedure for the treatment of spondylitis tuberculosis with kyphotic deformity was associated with good functional and radiological outcomes at long-term follow-up. Thus, we recommend this two-stage procedure as a standard for cases similar to our reported cases.

Original languageEnglish
Title of host publicationEncyclopedia of Surgery
Subtitle of host publicationVolume 1: (22 Volume Set)
PublisherNova Science Publishers, Inc.
Pages5577-5583
Number of pages7
Volume1
ISBN (Electronic)9781536183887
ISBN (Print)9781536183290
Publication statusPublished - 1 Jan 2020

Keywords

  • anterior fusion
  • kyphotic deformity
  • posterior stabilization
  • spondylitis tuberculosis

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