SEVERE KYPHOTIC DEFORMITY IN TUBERCULOSIS OF THE SPINE

Almost 3% of cases of tuberculosis of the spine develop a severe kypho tic deformity. The patients at risk are those who developed the diseas e under the age of 10 years, who had involvement of three or more vert ebral bodies and had lesions between C7 to L1. A severe kyphosis is mo re than a cosmetic disfigurement because nearly all such patients deve lop cardiopulmonary dysfunction, painful impingement between ribs and pelvis and compression of the spinal cord with paraplegia at an averag e of 10 years after the onset of the disease. Correction of the establ ished deformity is difficult and dangerous. Anterior transposition of the cord does not always result in permanent neurological recovery, so it is imperative to diagnose and treat the condition either before bo ny destruction has occurred or when it is in an early phase. Those pat ients who are at risk of developing a severe deformity should be treat ed by posterior fusion of the spine.