Behaviour of the kyphotic angle in spinal tuberculosis

We followed 70 adult patients with spinal tuberculosis for a minimum of 2 years. Forty patients were treated by ambulant multi-drug chemotherapy (group A), and 30 with neurological complications (group B) were treated by antero-lateral decompression and chemotherapy. We studied the angle of spinal kyphosis as calculated on lateral spinal X-ray by the modified Konstam’s method. The angle at final follow-up was compared with the pre-treatment angle. The relationship between the amount of initial vertebral loss, the predicted kyphotic angle and the observed kyphotic angle was analysed. Mean initial vertebral loss, mean pre-treatment angle and mean observed kyphotic angle in group A were 0.77°, 24.3°and 31.75° respectively, with a mean increase in angle of 7.4°. In group B, the readings were 0.67 , 25.9° and 26.8° respectively, with a mean increase in angle of 0.9°. Kyphotic deformity continued to progress until 2 years’ follow-up. Progression was more pronounced in the non-operative group.