Late treatment of tuberculosis-associated kyphosis: Literature review and experience from a SRS-GOP site

Oheneba Boachie-Adjei, Elias C. Papadopoulos, Ferran Pellisé, Matthew E. Cunningham, Francisco Sanchez Perez-Grueso, Munish Gupta, Baron Lonner, Kenneth Paonessa, Akilah King, Cristina Sacramento, Han Jo Kim, Michael Mendelow, Muharrem Yazici

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Introduction Spinal tuberculosis (TB) accounts for approximately half of all cases of musculoskeletal tuberculosis. Kyphosis is the rule in spinal tuberculosis and has potential detrimental effects on both the spinal cord and pulmonary function. Late-onset paraplegia is best avoided with the surgical correction of severe kyphosis, where at the same time anterior decompression of the cord is performed and the remnants of the tuberculosis-destroyed vertebral bodies are excised. Material and methods Review of the literature on late surgical treatment of TB-associated kyphosis; description and comparative analysis of the different surgical techniques. Results Kyphosis can be corrected either at the acute stage or at the healed late stage of tuberculous infection. In the late stage, the stiffness of the spine and chronic lung disease are additional considerations for the surgical approach and technique. Contrary to the traditional anterior transpleural approach used in the acute spinal tuberculosis infection, extrapleural approaches, either antero-lateral or direct posterior, are favored in late treatment. Conclusion The correction of deformity is only feasible with three-column osteotomies, and posterior vertebral column resection (PVCR) is the treatment of choice in extreme kyphosis. The prognosis of the neurologic deficit (late paraplegia) is dependent on the extent of gliosis of the spinal cord.

Original languageEnglish (US)
JournalEuropean Spine Journal
Volume22
Issue numberSUPPL.4
DOIs
StatePublished - Jun 2013

Keywords

  • Kyphosis
  • Late
  • Osteotomies
  • Posterior vertebral column resection
  • Postinfectious
  • PVCR
  • Tuberculous

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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    Boachie-Adjei, O., Papadopoulos, E. C., Pellisé, F., Cunningham, M. E., Perez-Grueso, F. S., Gupta, M., Lonner, B., Paonessa, K., King, A., Sacramento, C., Kim, H. J., Mendelow, M., & Yazici, M. (2013). Late treatment of tuberculosis-associated kyphosis: Literature review and experience from a SRS-GOP site. European Spine Journal, 22(SUPPL.4). https://doi.org/10.1007/s00586-012-2338-4