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Journal of Korean Neurosurgical Society 1997;26(4): 548-554.
Six Cases of Thoraco-lumbar Tuberculosis Treated by Anterior Decompression and Fusion with or withought Instrumentation.
Soo Chan Jang, Dong Soo Kang, Hwan Yung Chung, Sang Gu Lee, Ki Soo Han, Young Bo Kim, Cheol Wan Park, Uhn Lee
Department of Neurosurgery, Central Gil General Hospital, Inchun, Korea.
ABSTRACT
The anterior decompression and fusion have been the choice of surgical treatment for spinal tuberculosis since 1960. From April 1995 to April 1996, we operated on six patients of thoraco-lumbar tuberculosis. The procedure consisted of anterior decompression through corpectomy, stabilization with anterior instrument and bone graft with or without Titanium MESH. MRI provides a valuable information about the extent of the disease in multiple planes, thereby helping surgeons in planning of the operation. The thoracic spine was involed in four patients, the lumbar spine in two. On average, two vertebral bodies were involved. Anterior and middle column of spine were involved in all patients, but posterior column was intact in all patients. Disc space involvement was seen in all patients. Paraspinal abscess was observed in three patients. Epidural compression of the spinal cord or cauda equina was noted in all patients. Four patients showed neurological improvements and relief of pain. However, the recovery of two remaning paraplegic patients was not remarkable. There was no single case associated with persistence or recurrence of infection after instrumentation.
Key Words: Thoraco-lumbar spine; Instrumentation; Anterior decompression and fusion; Spinal tuberculosis
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