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A new classification and guide for surgical treatment of spinal tuberculosis

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Abstract

So far, there is no widely accepted classification system based on objective findings that can serve as a guide in selecting the treatment method for spinal tuberculosis. This retrospective study evaluates patients with spinal tuberculosis (Pott’s disease) treated with different surgical procedures. Our aim was to outline a new classification of spinal tuberculosis. A retrospective review of 76 cases (55 male and 25 female patients) of spinal tuberculosis was conducted. Five of the patients were treated medically, and the others who were treated surgically were classified into three types (I, II and III) according to the new classification system for spinal tuberculosis. All 76 patients were classifiable by this new system. The most common complication observed was local kyphosis (maximum 8 degrees) in type-II patients, but none of the patients needed correction. No neurological deterioration was observed in any of the cases. This new classification system helps in differentiating the various manifestations of spinal tuberculosis and appears to correlate with the surgical treatment of spinal tuberculosis. We believe that this new classification system can be used as a practical guide in the treatment of Pott’s disease.

Résumé

Il n’y a pas de système permettant de classer de façon objective les méthodes de traitement de la tuberculose osseuse. Cette étude rétrospective évalue les patients présentant une maladie de Pott, traités avec différentes techniques dans le but avoué de mettre en évidence une nouvelle classification de cette pathologie. Une étude rétrospective de 76 cas (55 hommes et 25 femmes) de tuberculose osseuse a été réalisée. Cinq patients ont été traités médicalement, les autres chirurgicalement en les classant en trois types A, B et C, selon la nouvelle classification. Les 76 patients ont été classés avec ce nouveau système. La complication la plus habituelle observée a été la cyphose locale (max. 8°) dans les types II. Mais il n’a pas été nécessaire chez ces patients de réaliser une correction chirurgicale. Nous n’avons observé aucune détérioration sur le plan neurologique. Cette nouvelle classification permet de différencier les différentes manifestations de la tuberculose osseuse et permet de faire une corrélation avec le traitement chirurgical. Nous espérons qu’elle pourra être utilisée et réaliser ainsi un guide pratique du traitement du mal de Pott.

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Oguz, E., Sehirlioglu, A., Altinmakas, M. et al. A new classification and guide for surgical treatment of spinal tuberculosis. International Orthopaedics (SICO 32, 127–133 (2008). https://doi.org/10.1007/s00264-006-0278-5

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