CONSERVATIVE TREATMENT OF TUBERCULOUS SPONDYLITIS - A LONG-TERM FOLLOW-UP-STUDY

A retrospective follow-up study was performed on 40 patients, in which tuberculous spondylitis was treated conservatively between 1969 and 1 985 with orthotic supports for an average of 16 months (range, 10-30 m onths) and with antituberculous agents. All had persistent back pain, but none had neurological deficits. The mean follow-up period was 17 y ears (range, 10-26 years). Diagnosis was confirmed histopathologically . The spinal segments involved ranged from T5 to L5. The kyphotic angl e was calculated according to Cobb. At final follow-up, 22 patients we re pain free, 11 had occasional pain, 6 complained of pain in the morn ing, and 1 had chronic pain and needed frequent analgesics. Solid bony union was found in 75% of patients. The kyphotic deformity occurred i n the thoracic spine with a mean angle of 20 degrees (range, 13-28 deg rees) and in the lumbar spine with a mean angle 12 degrees (range, 5-2 6 degrees). The long-term follow-up of conservative treatment showed o nly slightly increased kyphosis. Conservative treatment is an alternat ive to surgical intervention in cases with kyphosis <35 degrees.