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Conservative treatment of tuberculosis of the thoracic and lumbar spine in adults and children

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Summary

We have treated 75 cases of spinal tuberculosis with chemotherapy as outpatients. The drugs used were INH, rifampicin and ethambutol for the 48 adults, and INH, rifampicin and PAS for the 27 children. No operations, apart from the evacuation of large abscesses, were carried out. Every patient was followed up for at least three years and the outcome was judged to be favourable in 95%. This is better than in some series in which radical surgery has been used. Although we recognize the advantages of operation in certain circumstances, we believe that our conservative regimen can be confidently recommended for use in less privileged countries, where adequate facilities for hospital treatment may not be available.

Résumé

Nous avons traité médicalement, en malades externes, 75 cas de tuberculose rachidienne. Les médicaments utilisés ont été INH, Rifampicine et Ethambutol chez les 48 adultes, et INH, Rifampicine et PAS chez les 27 enfants. Aucune intervention, hormis l'évacuation d'abcès volumineux, n'a été réalisée. Tous les malades ont été suivis au moins trois ans et le résultat a été jugé bon dans 95% des cas. Ceci est meilleur que certaines séries où l'on a eu recours à une chirurgie radicale. Bien que nous reconnaissions les avantages du traitement chirurgical dans certains cas, nous pensons que notre traitement conservateur peut être recommandé en toute confiance dans les pays tels que la Corée qui ne disposent pas des moyens nécessaires pour soigner ces malades en milieu hospitalier.

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References

  1. Ahn BH (1968) Treatment for Pott's paraplegia. Acta Orthop Scand 39: 145–160

    Google Scholar 

  2. Bailey HL, Gabriel M, Hodgson AR, Shin JS (1972) Tuberculosis of the spine in children. J Bone Joint Surg 54-A: 1633–1651

    Google Scholar 

  3. Bakalim G (1960) Tuberculous spondylitis. A clinical study with special reference to the significance of spinal fusion and chemotherapy. Acta Orthop Scand [Suppl] No 47

  4. Chen HT (1969) Tuberculosis of the spine, children. J Western Pacific Orthop Assoc 1: 47–62

    Google Scholar 

  5. Chu CB (1967) Treatment of spinal tuberculosis in Korea using focal debridement and interbody fusion. Clin Orthop 50: 235–253

    Google Scholar 

  6. Cleveland M, Bosworth DM, Fielding JW (1958) Fusion of the spine for tuberculosis in children. J Bone Joint Surg: 40-A: 91–107

    Google Scholar 

  7. Dekel S, Francis MJO (1981) Hematogenous osteomyelitis and staphylococcus aureus. Postgrad Med 6: 131–134

    Google Scholar 

  8. Dekel S, Francis MJO (1981) The treatment of osteomyelitis of the tibia with sodium salicylate. J Bone Joint Surg 63-B: 178–184

    Google Scholar 

  9. Dekel S, Lenthall G, Francis MJO (1981) Release of prostaglandins from bone and muscle after tibial fracture. J Bone Joint Surg 63-B: 185–189

    Google Scholar 

  10. Dickson JAS (1967) Spinal tuberculosis in Nigerian children. A review of ambulant treatment. J Bone Joint Surg 49-B: 682–694

    Google Scholar 

  11. Fellander M (1954) Radical operation in tuberculosis of the spine. Acta Orthop Scand [Suppl] No 19

  12. Fountain SS, Hsu LCS, Yau ACMC, Hodgson AR (1975) Progressive kyphosis following solid anterior spine fusion in children with tuberculosis of the spine. J Bone Joint Surg 57-A: 1104–1107

    Google Scholar 

  13. Friedman B (1966) Chemotherapy of tuberculosis of the spine. J Bone Joint Surg 48-A: 451–474

    Google Scholar 

  14. Griffiths DL (1953) Pott's paraplegia and its operative treatment. J Bone Joint Surg 35-B: 487–493

    Google Scholar 

  15. Hodgson AR, Stock FE (1960) Anterior spine fusion for the treatment of tuberculosis of the spine; the operative findings and results of treatment in the first 100 cases. J Bone Joint Surg 42-A: 295–310

    Google Scholar 

  16. Kirkaldy-Willis WH, Thomas TG (1965) Anterior approaches in the diagnosis and treatment of infection of the vertebral bodies. J Bone Joint Surg 47-A: 87–110

    Google Scholar 

  17. Kondo R, Yamada K (1957) End results of local debridement in bone and joint tuberculosis and its indication. J Bone Joint Surg 39-A: 27–31

    Google Scholar 

  18. Kohli SB (1967) Radical surgical approach to spinal tuberculosis. J Bone Joint Surg 49-B: 668–681

    Google Scholar 

  19. Konstam PG, Blesovsky A (1962) The ambulant treatment of spinal tuberculosis. Br J Surg 50: 26–38

    Google Scholar 

  20. Konstam PG, Konstam ST (1958) Spinal tuberculosis in Southern Nigeria with special reference to ambulant treatment of throacolumbar disease. J Bone Joint Surg 40-B: 26–32

    Google Scholar 

  21. Medical Research Council Working Party on Tuberculosis of Spine (1973) A controlled trial of ambulant out-patient and in-patient rest in bed in the management of tuberculosis of the spine in young Korean patients on standard chemotherapy. J Bone Joint Surg 55-B: 678–697

    Google Scholar 

  22. Medical Research Council Working Party on Tuberculosis of Spine (1978) Five-year assessments of controlled trials of ambulatory treatment, debridement and anterior spinal fusion in the management of tuberculosis of the spine. Studies in Rhodesia and Hong Kong. J Bone Joint Surg 60-B: 163–176

    Google Scholar 

  23. Medical Research Council Working Party on Tuberculosis of Spine (1982) A 10-year assessment of controlled trials comparing debridement and anterior spinal fusion in the management of tuberculosis of the spine in patients on standard chemotherapy in Hong Kong. J Bone Joint Surg 64-B: 393–398

    Google Scholar 

  24. Medical Research Council Working Party on Tuberculosis of Spine (1985) A 10-year assessment of controlled trials of inpatient and outpatient treatment and of plaster of Paris Jackets for tuberculosis of the spine in children on standard chemotherapy. Studies in Masan and Pusan, Korea. J Bone Joint Surg 67-B: 103–110

    Google Scholar 

  25. Moon MS, Yu CI (1970) Ambulatory treatment of tuberculous spine in the children. J Korean Orthop Assoc 5: 155–162

    Google Scholar 

  26. Moon MS, Lee MK (1971) A study on the change of the kyphosis of the tuberculous spine in children following ambulatory treatment. J. Korean Orthop Assoc 6: 203–208

    Google Scholar 

  27. Moon MS, Woo YK (1978) Pulmonary function in adult with tuberculous kyphosis of the spine. J Western Pacific Orthop Assoc 15: 1–14

    Google Scholar 

  28. Moon MS (1983) Treatment of spinal infections. Commemorative issue, 3rd spinal section congress. J Western Pacif Orthop Assoc 7–11

  29. Moon MS, Kim I, Ok IY, Lee KS, Kang YK (1985) Posterior instrumentation for the treatment of active dorsolumbar tuberculosis with kyphosis proceedings. 8th Western Pacific Orthop Assoc Congress, Bangkok, Thailand

  30. Paus B (1964) Treatment of tuberculosis of the spine. Acta Orthop Scand [Suppl] No 72

  31. Risko T, Novoszel T (1963) Experiences with radical operations in tuberculosis of the spine. J Bone Joint Surg 45-A: 53–68

    Google Scholar 

  32. Roaf R (1960) Vertebral growth and its mechanical control. J Bone Joint Surg 42-B: 40–58

    Google Scholar 

  33. Shanks SC, Kerly P (1971) Tuberculosis of the spine. Textbook of vol VI, 4th ed, pp 297–304, WB Saunders, Philadelphia and Toronto

    Google Scholar 

  34. Stevenson FH, Manning CW (1962) Tuberculosis of the spine treated conservatively with chemotherapy. A series of 72 patients collected between 1949–1954, and followed to 1961. Tubercle 43: 406–411

    Google Scholar 

  35. Swett PP, Bennet GE, Street DM (1940) Pott's disease: The initial lesion, the relative infrequency of extension by contiguity, the nature and type of healing, the role of the abscess, and merits of operative and nonoperative treatment. J Bone Joint Surg 22: 878–894

    Google Scholar 

  36. Tuli SM, Kumar S (1971) Early results of treatment of spinal tuberculosis by triple drug therapy. Clin Orthop 81: 56–70

    Google Scholar 

  37. Tuli SM (1975) Results of treatment of spinal tuberculosis by “Middle-Path” regime. J Bone Joint Surg 57-B: 13–23

    Google Scholar 

  38. Wilkinson ME (1959) Treatment of tuberculosis of spine. Br Med J 5147-280-2: 29

    Google Scholar 

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  1. Kang-Nam St-Mary's Hospital, Catholic University Medical College, Seoul, Korea

    M. -S. Moon, I. Kim, Y. -K. Woo & Y. -O. Park

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  1. M. -S. Moon
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  2. I. Kim
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  3. Y. -K. Woo
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  4. Y. -O. Park
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Moon, M.S., Kim, I., Woo, Y.K. et al. Conservative treatment of tuberculosis of the thoracic and lumbar spine in adults and children. International Orthopaedics 11, 315–322 (1987). https://doi.org/10.1007/BF00271307

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