The Efficacy of Titanium Mesh Cage in Tuberculous Spondylitis Treated with Anterior Intervertebral Fusion.

Jeong, Ju Ho; Lee, Sang Gu; Yoo, Chan Jong; Han, Ki Soo; Kim, Woo Kyung; Kim, Young Bo; Park, Cheol Wan; Lee, Uhn

Original Article

Journal of Korean Neurosurgical Society 2001;30(8): 998-1003.

Ju Ho Jeong, Sang Gu Lee, Chan Jong Yoo, Ki Soo Han, Woo Kyung Kim, Young Bo Kim, Cheol Wan Park, Uhn Lee

Department of Neurosurgery, Gachon Medical School, Gil Medical Center, Incheon, Korea.

ABSTRACT

OBJECTIVE
The maintenance of the correction of kyphotic deformity is one of the difficult problem in tuberculous spondylitis after anterior debriment and fusion with tricortical bone graft. The goal of this study is to find out the efficacy of titanium mesh cage impacted with autogenous bone chip in tuberculous spondylitis treated with anterior intervertebral fusion. MATERIALS AND METHODS: Twelve patients were treated with anterior intervertebral fusion using titanium mesh cage for tuberculous spondylitis from January 1996 to June 1999. We analized the changes in the correction of kyphotic deformity, changes of ESR and CRP, fusion state and recurrence after anterior intervertebral fusion with titanium mesh cage.
RESULTS
Clinical symptoms were improved in all twelve patients without any neurologic complications. The mean kyphotic angle corrected was 7.3 degrees immediately after operation, but the loss of correction of kyphotic angle was 2.2 degrees after 3 months and 2.6 degrees after 6 months. We found that the loss of correction of kyphotic deformity occurred mainly within the first 3 months after surgery. Only one patient, suffered from acute hepatic failure after first operation and had an insufficient anti-tuberculous medication therapy, showed recurrence of tuberculous spondylitis after 6 months. The patient underwent a second operation with posterior fixation procedure with good outcome. The changes of ESR and CRP were not specifically important factor to reveal recurrence of tuberculosis of the spine in our series.
CONCLUSION
The surgical procedure of tuberculous spondylitis using titanium mesh cage with bone chip seems to be an effective procedure to minimize loss of the correction of kyphotic deformity without any aggravating inflammatory change and recurrence with titanium mesh cage, when sufficient debridement and anti-tuberculous chemotherapy are achieved.

Key Words: Tuberculous spondylitis; Titanium mesh cage; Kyphtic deformity; Recurrence