Infections of the spine usually involve the vertebral body and therefore by definition produce a
kyphosis. Non-tuberculous
infection usually staphylococcal and in the lumbar spine, is often diagnosed late and can involve the cord. Open exploration and stabilization with graft should therefore be considered. The destruction is usually less extensive and therefore the
kyphosis less severe than in late neglected tuberculous
infections. Tuberculous spinal
infection accounts for 59% of all orthopedic
tuberculosis. It invariably involves vertebral bodies and is progressive. Destruction of the bodies is by
infection and avascular
necrosis,
kyphosis is inevitable and cord compression a common threat. While L-1 is the most commonly affected body T-10 is statistically the most commonly associated with cord compression. The treatment of
spinal tuberculosis should be aimed at correcting 5 basic defects associated with the disease and the
deformity: mechanical instability; chronic smoldering
infection; spinal cord and
nerve root compression; disturbance of spinal growth; depressed lung function. The cornerstone to effective treatment for
spinal tuberculosis is
drug therapy and the anterior fusion operation. For the established tuberculous
kyphosis, which is always a fixed
deformity, multiple staged operations and gradual correction used the Halo-pelvic apparatus is the best treatment available at present.