Türk Nöroşirürji Dergisi 2001 , Vol 11 , Num 3
Metin TUNA, Tahsin ERMAN, A İskender GÖÇER, Faruk İLDAN, Erdal ÇETİNALP
Çukurova Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı, Adana The goals of treatment of tuberculous spond ylitis are eradication of the infection, correction or prevention of spinal deformity and preservation or improvement of neurological function. The choice of treatment of tuberculous spondylitis includes many procedures such as chemotherapy, immobilization, surgical debridement, radical resection, bone grafting, instrumentation or combination of these procedures. Six cases with thoracic or lumbar tuberculous spondylitis that undergo primary reconstruction including radical corpectomy-debridement, intercorporal insertion of an allograft and anterior instrumentation were the subjects of this retrospective review. Solid bony fusion and healing of the infection were achieved in all cases. All cases obtained immediate relief of pain, and no late recurrent spinal infection was encountered after discontinuing antituberculous chemotherapy. Instrument failure or operative complication did not occur in any cases. Only two cases underwent a mean loss of reduction of 5 degrees during the follow-up period. The neurological function of 5 of the 6 cases was improved by an average of 1.5 grades. The other one who had complete paraplegia preoperatively had experienced no change. The authors conclude that primary reconstruction and antituberculous chemotherapy are an effective method in order to provide permanent eradication of spinal focus of tuberculous infection, spinal stabilization, prevention of loss of reduction and preservation or improvement of neurological function. Anahtar Kelimeler : Allograft, radical corpectomy-debridement, spinal instrumentation, tuberculous spondylitis