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  • Outcome of Surgical versus Conservative Management of Cervical Spine Myelopathy Secondary to Cervical Tuberculosis

    Final Number:
    1193

    Authors:
    Ahmed Mohamed Elsawaf MD PhD

    Study Design:
    Clinical Trial

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2017 Annual Meeting

    Introduction: Cervical spine tuberculosis is a rare infectious disease that is not yet discussed well regarding the optimal method of its management

    Methods: A prospective study of a total of 29 patients with cervical spine tuberculosis with a mean follow-up of 14 months (range 10-21), they were classified randomly into two groups: Group I: Patients who underwent anterior cervical decompression and fixation and followed by the anti-tuberculous medications (16 patients). Group II: Patients who had conservative anti-tuberculous medications only without surgical intervention (13 patients). All patients had complete clinical assessments using Nurick scale and the modified Japanese Orthopaedic Association (mJOA) score for myelopathy and the visual analogue scale (VAS) for assessment of cervical pain. We had also neuro-radiographic assessment (cervical spine X-ray and MRI) at the first presentation and at 3, 6 and 12 months later

    Results: At final follow-up, significant neurological improvement was demonstrated in both managemnt approaches, more obvious in the surgical group. Cervical pain showed statistically significant improvemnt (P<0.05) in surgical group rather than in conservatively-treated group. In the surgical group, the mean Cobb angle showed significant change from a preoperative mean of - 3.1?? 1.6 to postoperative mean of 16.6?? 5.4, significantly corretaled to the improvement of cervical pain (P = 0.004), while it was changed from a mean - 0.8 ± 2.2 to a mean of 9.2 ± 3.8 one year after starting of medical treatment in group II

    Conclusions: In spite of the conservative trend in the management of Pott’s disease, surgical management of cervical spine myelopathy secondary to cervical tuberculosis could be the optimal treatment even in an early stage of the disease

    Patient Care: giving idea about management of cervical Pott's disease

    Learning Objectives: optimal management of cervical spine tuberculosis

    References:

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