Skip to main content

Surgical Management of Spinal Tuberculosis

  • Chapter
Tuberculosis

Abstract

Surgical Intervention in the treatment of spinal tuberculosis (TB) antedated the discovery of the antibiotics. Although some of these innovative surgical procedures were successful, the outcome was poor due to the fact that surgery was not supplemented with the yet undiscovered anti-microbial agents.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Abramovitz JN, Batson RA, Yablon JS (1986) Vertebral osteomyelitis: the surgical management of neurologic complications. Spine 11:418–420

    Article  PubMed  CAS  Google Scholar 

  • Al Arabi KM, Al Sebai MW (1991) Bifacetal dislocation following tuberculosis of the cervical spine. Tubercle 72: 294–298

    Article  PubMed  CAS  Google Scholar 

  • Al Arabi KM, Al Sebai MW, Al Chakaki M (1992) Evaluation of radiological investigations in spinal tuberculosis. Int Orthop 16:165–167

    Article  PubMed  CAS  Google Scholar 

  • Albee FH (1911) Transplantation of a portion of the tibia into the spine for Pott’s disease: a preliminary report. JAMA 57: 885–886

    Article  Google Scholar 

  • Al Sebai MW et al (2001) Operative treatment of progressive deformity in spinal tuberculosis. Int Orthop 25:322–325

    Article  PubMed  CAS  Google Scholar 

  • Altman GT, Altman DT, Frankovitch KF (1996) Anterior and posterior fusion for children with tuberculosis of the spine. Clin Orthop Relat Res 325:225–231

    Article  PubMed  Google Scholar 

  • Arumagasamy N, Pyn CC, Keng KK (1977) Tuberculous abscesses of the cervical spine with quadriparesis. Surg Neurol 8:35–40

    Google Scholar 

  • Bailey HL et al (1972) Tuberculosis of the spine in children. J Bone Joint Surg 54A: 1633–1657

    Google Scholar 

  • Boachie-Adjei O, Squillante RG (1996) Tuberculosis of the spine. Orthop Clin North Am 27:95–103

    PubMed  CAS  Google Scholar 

  • Bradford DS, Daher XH (1986) Vascularized rib grafts for stabilization of Kyphosis. J Bone Joint Surg 68B:357–361

    Google Scholar 

  • Bront ZM, Burke VD, Jeffrey RB (1983) CT in the evaluation of spine infection. Spine 8:358–364

    Article  Google Scholar 

  • Dobson J (1951) Tuberculosis of the spine. Analysis of the results of conservative treatment and of the factors influencing the prognosis. J Bone Joint Surg 33B:517–531

    Google Scholar 

  • Fellander M (1975) Paraplegia in spondylitis: results of operative treatment. Paraplegia 13:75–88

    Article  PubMed  CAS  Google Scholar 

  • Govender S, Parbhoo AH (1999) Support of the anterior column with allografts in tuberculosis of the spine. J Bone Joint Surg 81:106–109

    Article  CAS  Google Scholar 

  • Graziano GP, Sidhu KS (1993) Salvage reconstruction in acute and late sequelae from pyogenic thoracolumbar infection. J Spinal Discord 6:199–207

    Article  CAS  Google Scholar 

  • Gristina AG, Costerton JW (1985) Bacterial adherence and the glycocalyx and their role in musculoskeletal infection. Orthop Clin North Am 15:517–535

    Google Scholar 

  • Gristina AG et al (1985) Bacterial adherence and the pathogenesis of osteomyelitis. Science 228:99–103

    Article  Google Scholar 

  • Gupta RK et al (1993) Ultrasound-guided needle biopsy of lytic lesions of the cervical spine. J Clin Ultrasound 21:194–197

    Article  PubMed  CAS  Google Scholar 

  • Guven O et al (1994a) A Single stage posterior approach and rigid fixation for preventing Kyphosis in the treatment of spinal tuberculosis. Spine 19:1039–1043

    Article  PubMed  CAS  Google Scholar 

  • Guven O, Yalcin S, Karahan M (1994b) Eggshell procedure in correction of neglected cases of Pott’s Kyphosis. Proceedings of the 5th biannual Conference of European Spinal Deformities Society. Birmingham, England. Springer, Berlin Heidelberg New York, pp 84–85

    Google Scholar 

  • Hibbs RA (1911) An Operation for progressive spinal deformities. NY State Med J 93:1013–1016

    Google Scholar 

  • Hodgson AR, Stock FE (1956) Anterior spinal fusion: a preliminary communication on the radical treatment of Pott’s disease and Pott’s paraplegia. Br J Surg 44:266–275

    Article  PubMed  CAS  Google Scholar 

  • Hodgson AR, Stock FE (1960) Anterior spinal fusion for the treatment of tuberculosis of the spine. J Bone Joint Surg 42A:295

    Google Scholar 

  • Hodgson AR et al (1964) A clinical study of 100 consecutive cases of Potfs paraplegia. Clin Orthop 36:128–150

    Google Scholar 

  • Hsu LCS, Leong JCY (1984) Tuberculosis of the lower cervical spine (C2 t C7). J Bone Joint Surg 66B:1–5

    Google Scholar 

  • Ito H, Tsuchiya J, Asami G (1934) A new radical Operation for Potfs disease: report of then cases. J Bone Joint Surg 16: 499–515

    Google Scholar 

  • Jain R, Sawhney S, Berry M (1993) Computed tomography of vertebral tuberculosis: patterns of bone destruction. Clin Radiol 47:196–199

    Article  PubMed  CAS  Google Scholar 

  • Jeanneret B, Magerl F (1994) Treatment of osteomyelitis of the spine using percutaneous suction/irrigation and percutaneous external spinal fixation. J Spinal Disord 7:185–205

    Article  PubMed  CAS  Google Scholar 

  • Kang M et al (1999) CT guided fine needle aspiration biopsy of spinal lesions. Acta Radiol 40:474–478

    Article  PubMed  CAS  Google Scholar 

  • Kattapuram SV, Rosenthal DI (1987) Percutaneous biopsy of the cervical spine using CT guideance. AJR 149:539–541

    Article  PubMed  CAS  Google Scholar 

  • Kemp HBS, Jackson JW, Shaw NC (1974) Laminectomy in paraplegia due to infective spondylitis. Br J Surg 61:66–72

    Article  PubMed  CAS  Google Scholar 

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

    Google Scholar 

  • Kondo E, Yamada K (1937) End results of focal debridement in bone and Joint tuberculosis and its indications. J Bone Joint Surg 39A:27

    Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  • Konstam PG, Konstam ST (1958) Spinal tuberculosis in southern Nigeria: with Special reference to ambulant treatment of thoraco-lumbar disease. J Bone Joint Surg 40B:26–32

    Google Scholar 

  • Korkusuz F, Islam C, Korkusuz Z (1997) Prevention of postoperative late Kyphosis in Pott’s disease by anterior decompression and intervertebral grafting. World J Surg 21:524–528

    Article  PubMed  CAS  Google Scholar 

  • Kostuik JP (1983) Anterior spinal cord decompression of lesions of the thoracic and lumbar spine, techniques, new methods of internal fixation. Spine 8:512–531

    Article  PubMed  CAS  Google Scholar 

  • Lee TC et al (1999) Transpedicular instrumentation as an adjunct in the treatment of thoracolumbar and lumbar spine tuberculosis with early stage bone destruction. J Neurosurg 91[Suppl 2]:163–169

    PubMed  CAS  Google Scholar 

  • Lifeso R (1987) Atlanto-axial tuberculosis in adults. J Bone Joint Surg 69(B):183–187

    CAS  Google Scholar 

  • Lifeso RM, Weaver P, Härder EH (1985) Tuberculosis spondylitis in adults. J Bone Joint Surg 67A:1405–1413

    Google Scholar 

  • Luk KD (1999) Tuberculosis of the spine in the new millennium. Eur Spine J 8:338–345

    Article  PubMed  CAS  Google Scholar 

  • Martin NS (1970) Tuberculosis of the spine. A study of the results of treatment during the last twenty-five years. J Bone Joint Surg 52B:613–628

    Google Scholar 

  • McGraham JP, Dublin AB (1985) Evaluation of spinal infection by piain radiographs, computed tomography, intrathecal metrizamide and CT guided biopsy. Diagn Imag Clin Med 54:11–20

    Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, First Report (1973a) A controlled trial of ambulant out-patient treatment and in-patient rest in bed in the management of tuberculosis of the spine in young Korean patients on Standard chemotherapy. A study in Masan, Korea. J Bone Joint Surg 55B-.678–697

    Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, Second Report (1973b) A controlled trial of plaster of Paris jackets in the management of ambulant outpatient treatment of tuberculosis of the spine in children on Standard chemotherapy: a study in Pusan, Korea. Tubercle 54:261–282

    Article  Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, Third Report (1974a) A controlled trial of debridement and ambulatory treatment in the management of tuberculosis of the spine in patients on Standard chemotherapy: a study in Bulawayo, Rhodesia. J Trop Med Hyg 77:72–92

    Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, Fourth Report (1974b) A controlled trial of anterior spinal fusion and debridement in the surgical management of tuberculosis of the spine in patients on Standard chemotherapy: a study in Hong Kong. Br J Surg 61:853–866

    Article  Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, Fifth Report (1976) A five-year assessment of controlled trials in in-patient and out-patient treatment and plaster of Paris jackets for tuberculosis of the spine in children on Standard chemotherapy. Studies in Masan and Pusan, Korea. J Bone Joint Surg 58B:399–411

    Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, Sixth Report (1978a) Five year assessments of controlled trials of ambulatory treatment, debridement and anterior spinal fusion in the management of tuberculosis of the spine: studies in Vulawayo (Rhodesia) and in Hong Kong. J Bone Surg 60B:163–177

    Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, Seventh Report (1978b) A controlled trial of anterior spinal fusion and debridement in the surgical management of tuberculosis of the spine in patients on Standard chemotherapy: a study in two centers in South Africa. Tubercle 59:79–105

    Article  Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, Eighth Report (1982) A 10 year assessment of a controlled trial 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 64B:393–398

    Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, Ninth Report (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 6B:103–110

    Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, Tenth Report (1986) A controlled trial of six month and nine month regimens of chemotherapy in patients undergoing radical surgery for tuberculosis of the spine in Hong Kong. Tubercle 67:243–259

    Article  Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine, Eleventh Report (1989) A comparison of 6 or 9 month course regime of chemotherapy in patients receiving ambulatory treatment or undergoing radical surgery for tuberculosis of the spine. Indian J Tuberc [Suppl] 36:1–21

    Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine. Thirteenth report (1998) A 15-year assessment of controlled trials of the management of tuberculosis of the spine in Korea and Hong Kong. J Bone Joint Surg 80B: 456–462

    Google Scholar 

  • Medical Research Council Working Party on Tuberculosis of the Spine. Fourteenth Report (1999) Five-year assessment of controlled trials of short-course chemotherapy regimens of 6,9 or 18 months duration for spinal tuberculosis in patients ambulatory from the Start or undergoing radical surgery. Int Orthop 23:73–81

    Article  Google Scholar 

  • Menard V (1894) Causes de paraplegie dans 1e mal de Pott. Son traitment Chirurgical Par Pouverture directe de goyer tuberculeuse des vertebras. Rev Orthop 5:47–54

    Google Scholar 

  • Moon MS (1991) Combined posterior instrumentation and anterior interbody fusion for active tuberculosis Kyphosis of the thoraxolumbar spine. Curr Orthop 5:177–179

    Article  Google Scholar 

  • Moon MS (1997) Tuberculosis of the spine. Controversies and a new challenge. Spine 22:1791–1797

    Article  PubMed  CAS  Google Scholar 

  • Moon MS et al (1987) Conservative treatment of tuberculosis of the thoracic and lumbar spine in adults and children. Int Orthop 11:315–322

    Article  PubMed  CAS  Google Scholar 

  • Moon MS et al (1995) Posterior instrumentation and anterior interbody fusion for tuberculosis Kyphosis of dorsal and lumbar spines. Spine 20:1910–1916

    Article  PubMed  CAS  Google Scholar 

  • Moon MS et al (1996) Pott’s paraplegia — 67 cases. Clin Orthop Relat Res 323:122–128

    Article  PubMed  Google Scholar 

  • Oga M et al (1993) Evaluation of the risk of instrumentation as a foreign body in spinal tuberculosis. Clinical and biologic study. Spine 18:1890–1894

    CAS  Google Scholar 

  • Pertuiset E (1999) Medical therapy of bone and Joint tuberculosis in 1998. Rev Rhumat 66:152–157

    CAS  Google Scholar 

  • Pott P (1936) Remarks on that kind of palsy of the lower limb, which is frequently found to accompany a curvature of the Spine, and is supposed to be caused by it. Williams and Wilkins, Baltimore MD, pp 271–323 (Medical classics, vol I)

    Google Scholar 

  • Rahman N, Al Arabi KM, Khan FA (1987) Atypical forms of spinal tuberculosis. Acta Neuro Chir 88:26–33

    Article  Google Scholar 

  • Rand C, Smith MA (1989) Anterior spinal tuberculosis: paraplegia following laminectomy. Ann R Coll Surg Engl 71:105–109

    PubMed  CAS  Google Scholar 

  • Rath SA et al (1996) Neurosurgical management of thoracic and lumbar vertebral osteomyelitis and discitis in adults: a review of 43 consecutive surgically treated patients. Neurosurgery 38:926–933

    Article  PubMed  CAS  Google Scholar 

  • Redfern RM et al (1988) Stabilization of the infected spine. J Neurol Neurosurg Psychiatry 51:803–897

    Article  PubMed  CAS  Google Scholar 

  • Rezai AR et al (1995) Modern management of spinal tuberculosis. Neurosurgery 36:87–97

    Article  PubMed  CAS  Google Scholar 

  • Schulitz KP et al (1997) Growth changes of solidly fused Kyphotic block after surgery for tuberculosis. Comparison of four procedures. Spine 22:1150–1155

    Article  CAS  Google Scholar 

  • Seddon HJ (1934/1935) Pott’s Paraplegia: prognosis and treatment. Br J Surg 22:769–799

    Article  Google Scholar 

  • Sharif HS et al (1993) Role of CT and MR imaging in the management of tuberculous spondylitis. Radiol Clin North Am 33:787–804

    Google Scholar 

  • Smith IE et al (1996) Kyphosis secondary to tuberculosis osteomyelitis as a cause of ventilatory failure. Chest 110: 1105–1110

    Article  PubMed  CAS  Google Scholar 

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

    Google Scholar 

  • Tuli SM (1995) Severe Kyphotic deformity in tuberculosis of the spine. Int Orthop 19:327–331

    Article  PubMed  CAS  Google Scholar 

  • Upadhyay SS et al (1993) 17-year prospective study of surgical management of spinal tuberculosis in children. Hong Kong Operation compared with debridement surgery for short and long term outcome of deformity. Spine 18: 1704–1711

    Article  PubMed  CAS  Google Scholar 

  • Upadhyay SS et al (1994) Surgical management of spinal tuberculosis in adults. Hong Kong Operation compared with debridement surgery for short and long term outcome of deformity. Clin Orthop Relat Res 302:173–182

    PubMed  Google Scholar 

  • Wu SS et al (1996) Management of rigid post-traumatic Kyphosis. Spine 21:2260–2267

    Article  PubMed  CAS  Google Scholar 

  • Yau AMC et al (1974) Tuberculous Kyphosis: correction with spinal osteotomy, halopelvic distraction, and anterior and posterior fusion. J Bone Joint Surg 56A: 1419–1434

    Google Scholar 

  • Yilmaz C et al (1999) Anterior instrumentation for the treatment of spinal tuberculosis. J Bone Joint Surg 81A: 1261–1267

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Al Sebai, M.W., Madkour, M.M., Al Moutaery, K.R. (2004). Surgical Management of Spinal Tuberculosis. In: Madkour, M.M. (eds) Tuberculosis. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-18937-1_31

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-18937-1_31

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-62365-3

  • Online ISBN: 978-3-642-18937-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics