Late treatment of tuberculosis-associated kyphosis: literature review and experience from a SRS-GOP site.
Summary of "Late treatment of tuberculosis-associated kyphosis: literature review and experience from a SRS-GOP site."
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.
Affiliation
Foundation of Orthopedics and Complex Spine, 523 East, 72nd Street, New York, NY, 10021, USA.
Journal Details
This article was published in the following journal.
Name: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the Euro
ISSN: 1432-0932
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22627623
- DOI: http://dx.doi.org/10.1007/s00586-012-2338-4
Medical and Biotech [MESH] Definitions
Review Literature As Topic
Published materials which provide an examination of recent or current literature. Review articles can cover a wide range of subject matter at various levels of completeness and comprehensiveness based on analyses of literature that may include research findings. The review may reflect the state of the art. It also includes reviews as a literary form.
Review
An article or book published after examination of published material on a subject. It may be comprehensive to various degrees and the time range of material scrutinized may be broad or narrow, but the reviews most often desired are reviews of the current literature. The textual material examined may be equally broad and can encompass, in medicine specifically, clinical material as well as experimental research or case reports. State-of-the-art reviews tend to address more current matters. A review of the literature must be differentiated from HISTORICAL ARTICLE on the same subject, but a review of historical literature is also within the scope of this publication type.
Concurrent Review
Review of the medical necessity of hospital or other health facility admissions, upon or within a short time following an admission, and periodic review of services provided during the course of treatment.
Tuberculosis Societies
Voluntary agencies concerned with prevention and treatment of tuberculosis.
Latent Tuberculosis
The dormant form of TUBERCULOSIS where the person shows no obvious symptoms and no sign of the causative agent (Mycobacterium tuberculosis) in the SPUTUM despite being positive for tuberculosis infection skin test.
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