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脊椎結核에 對한 脊椎前方 癒合術이 脊椎 後彎症 矯正에 미치는 影響에 關하여

A Study of Influences of the anterior Intervertevral Fusion upon the Correctability of Kyphosis in Tuberculous Spondylitis

대한정형외과학회지 1968년 3권 4호 p.31 ~ 40
李殷龍, 韓文植,
소속 상세정보
李殷龍 (  ) - 서울대학교 醫科大學 整形外科學敎室
韓文植 (  ) - 서울대학교 醫科大學 整形外科學敎室

Abstract


The treatment of kyphosis, as a disgraceful sign of tuberculous spondylitis, has been down for discussion. with the progression in the technic of radical operative treatment of main lesion. The intervertebral anterior fusion with strut bone graft has been accepted as not only the radical operative treatment for tuberculous spondylitis but also the method of correction for fixed deformity of spinal curvature by some authorities. It is the purpose of this study to figure out the correctability of kyphosis in tuberculous spondylitis which had been cured with the anterior intervertebral fusion for recent 5 years of duration from March 1963 to March 1968 in the Department of Orthopedic Surgery of Seoul National University Hospital.
The randomly selected 90 cases were reviewed with roentgenographical findings of preoperative, postoperative and follow-up kyphosis and the following conclusions are obtained.
1. The prevalance of spinal lesion in tuberculous spondylitis was revealed high in lower thoracic and upper lumber vertebral level. The average number-of involved vertebrae with tuberculous spondylitis is 2 vertebrae.
2. The correction of kyphosis, more or less in degree of it, was obtained in 92.2% at the immediate post
operative stage and also 75.8% on postoperative 3 months and 73.3% on postoperative 6 months.
3. The difference in correctability of kyphosis among the vertebral levels seemed not to be remarked but
a little prevalance in lumbar vertebral level.
4. In the growing children, the correctabilty of kyphosis had a tendency to be greater than in adult but the loss of correction of kyphosis also greater than in adult.
5. The remarkable maintenance of correction in kyphosis called out attention to the possibility of the anterior intervertabral spinal fusion for the treatment of the fixed deformities of spinal curvature as well as in the tuberculous spondyitis itself, in spite of the tendency towards the progressively increasing loss of corrected curvature with the passage of time.

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