Spinal brace in tuberculosis of spine

OBJECTIVE: To present our experience in the management of 22 patients with thoracolumbar spine tuberculosis (TB) using a chemotherapy regimen and locally custom-made spinal brace.

METHODS: Twenty-two patients with thoracolumbar spine TB had been treated conservatively by chemotherapy and locally custom-made spinal brace and followed for 36-48 months from June 1996 to June 2000 in the Department of Orthopedics and Trauma, Algamhoria Teaching Hospital, Aden, Republic of Yemen. In 14 cases, 2 vertebrae were involved, whereas in 8 cases involvement was only of one vertebra. All had persistent back pain: 2 had neurological deficit, Frankel grade A and B (9%), and 12 (54%) had gibbus deformity.

RESULTS: At the end of the observation period, all patients had no pain (based on the adjective rating scale). Fourteen thoracic and 3 psoas abscesses resolved by 18 months. Four cases (18%) had deterioration of the angle of kyphosis. Five cases (22.5%) had progressive vertebral loss. Twelve cases (84%) had bony fusion at 36 months.

CONCLUSION: Chemotherapy regimen and locally custom-made spinal brace is not costly, needs neither admission nor surgical intervention that demands skills and experience and can be recommended for uncomplicated thoracolumbar spinal TB.