Abstract
We followed 70 adult patients with spinal tuberculosis for a minimum of 2 years. Forty patients were treated by ambulant multi-drug chemotherapy (group A), and 30 with neurological complications (group B) were treated by antero-lateral decompression and chemotherapy. We studied the angle of spinal kyphosis as calculated on lateral spinal X-ray by the modified Konstam’s method. The angle at final follow-up was compared with the pre-treatment angle. The relationship between the amount of initial vertebral loss, the predicted kyphotic angle and the observed kyphotic angle was analysed. Mean initial vertebral loss, mean pre-treatment angle and mean observed kyphotic angle in group A were 0.77°, 24.3°and 31.75° respectively, with a mean increase in angle of 7.4°. In group B, the readings were 0.67 , 25.9° and 26.8° respectively, with a mean increase in angle of 0.9°. Kyphotic deformity continued to progress until 2 years’ follow-up. Progression was more pronounced in the non-operative group.
Résumé
Nous avons suivi 70 malades adultes avec une tuberculose de la colonne vertébrale pendant une période minimum de deux années. Quarante malades ont été traités par chimiothérapie multi—drogue ambulatoire (groupe A) et 30 malades avec des complications neurologiques (Groupe B) ont été traités par décompression antero—latérale et chimiothérapie. Nous avons étudié l’angle de cyphose vertébrale calculé sur cliché sagittal par la méthode de Konstam modifié. L’angle à la fin de l’étude a été comparé avec l’angle avant traitement dans les deux groupes. Les rapports entre le montant de la perte vertébrale initiale, l’angle prédictif de la cyphose et l’angle observé de la cyphose ont été analysés. Dans le groupe A, la perte initiale moyenne du corps vertébral, l’angle moyen du prétraitement et l’angle moyen observé étaient respectivement 0,77 , 24,3° et 31,75° avec une augmentation moyenne de l’angle de 7,4° tandis que dans le groupe B, les valeurs étaient 0,67°, 25,9° et 26,8° avec une augmentation moyenne de l’angle de 0,9°. La déformation de la cyphose a continué à progresser jusqu’à 2 années de suivi. La progression a été plus prononcée dans le groupe non-opéré.
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Jain, A.K., Aggarwal, P.K., Arora, A. et al. Behaviour of the kyphotic angle in spinal tuberculosis. International Orthopaedics (SICOT) 28, 110–114 (2004). https://doi.org/10.1007/s00264-003-0516-z
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DOI: https://doi.org/10.1007/s00264-003-0516-z