Out Come of Kelafong Procedure in The Treatment of Spinal Tuber Culosis
Keywords:
Kalafong Proceedure, Spine Tuberculosis, Neurological statusAbstract
ABSTRACT
Objective: To find the outcome of Kelafong procedure in the treatment of spinal tuberculosis
Methods: This prospective study was conducted on 8 patients diagnosed with active spine tuberculosis in the Department of Orthopedics Khyber Teaching Hospital, Peshawar from august, 2015 to December 2017 who underwent Kalafong procedure. Efficacy of Kalafong procedure was noted as improvement in neurological symptoms of a patient with spinal tuberculosis i.e. paraplegia, bowel and bladder symptoms after the Kalafong procedure measured according to Frankel et al [6] at the time of 06 months follow-up. Data was analyzed with SPSS version 20.
Results: The mean age of the patient was 50.35 years ±2.53SD with the age range of 15 to 55 years. There were 6 (75%) females and 2 (25%) males. The mean pre operative cob angle was 45.15 ± 2.73SD. The post operative Cobb angle was 42.38 ± 2.68SD. Three (37.5%) patients improved to nurological status A and B while 2 (25%) patients improved to Cnurological status.
Conlcusion: Kelafong procedure is effective in the treatment of spinal tuberculosis regarding improvement in neurological status.
References
2. Trecarichi EM, Di Meco E, Mazzotta V, Fantoni M. Tuberculous spondylodiscitis: epidemiology, clinical features, treatment, and outcome. Eur Rev Med Pharmacol Sci 2012 Apr;16 Suppl 2:58-72.
3. Moon MS. Tuberculosis of spine: current views in diagnosis and management. Asian Spine J 2014 Feb;8:97-111.
4. Bradford DS. Anterior vascular pedicle bone grafting for the treatment of kyphosis. Spine 1979 Jul;5(4):318-23.
5. Dick W. The "Fixatuer Interne" as a Versatile Implant for Spine. Surgery. Spine. 1987 Nov 1;12(9):882-900.
6. Frankel HL, Hancock DO, Hyslop G, Melzak J, Michaelis LS, Ungar GH. Et al. The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Spinal Cord. 1969 Nov;7(3):179-92.
7. GAINES Jr RW, Abernathie DL. Mersilene tapes as a substitute for wire in segmental spinal instrumentation for children. Spine.1986 Nov;11(9):907-13
8. Hodgson AR, Stock FE. Anterior spinal fusion a preliminary communication on the radical treatment of Pott's disease and Pott'sparaplegia. British journal of surgery. 1956 Nov;44(185):266-75.
9. Tao Zhang, Lihua Ma, XuLan, Ping Zhen, Shiyong Wang, Zhilin Li: One-Stage anterolateral Debridement, Bone Grafting, and Internal Fixation for Treating Lumbosacral Tuberculosis. Asian Spine J 2017 Apr;11(2):305-313.
10. Lifeso RM, Weaver P, Harder EH. Tuberculous spondylitis in adults. JBJS. 1985 Dec;67(9):1405-13.
11. Smith MG. Five year assessment of controlled trials of inpatient and outpatient treatment and of plaster of Paris jacket for tuberculosis of the spine in children on standard chemotherapy. Journal of Pediatric Surgery. 1977 1;12(4):624.
12. Dai LY, Jiang LS, Wang W, Cui YM. Single-stage anterior autogenous bone grafting and instrumentation in the surgical management of spinal tuberculosis. Spine. 2005 Oct 15;30(20):2342-9.
13. Brooker C. Churchill Livingstone Medical Dictionary E-Book. Elsevier Health Sciences; 2008 4.
14. Akshay Jain, R.K. Jain, Vivek Kiyawat. Evaluation of Outcome of Transpedicular Decompression and Instrumented Fusion in Thoracic and Thoracolumbar Tuberculosis. Asian Spine J 2017 Feb;11(1):31-36
15. Tao Zhang, Lihua Ma, XuLan, Ping Zhen, Shiyong Wang, Zhilin Li: One-Stage anterolateral Debridement, Bone Grafting, and Internal Fixation for Treating Lumbosacral Tuberculosis. Asian Spine J 2017 Apr;11(2):305-313
16. Jenkins DH, Hodgson AR, Yau AC, Dwyer AP, O'mahoney G. Stablization of the spine in the surgical treatment of severe spinal tuberculosis in children. Clinical orthopaedics and related research. 1974 Jul-Aug (110):69-80.
17. Rose GK, Owen R, Sanderson JM. Transposition of rib with blood supply for the stabilization of a spinal kyphosis. J Bone Joint Surg. 1975;57:112.
18. Kemp MH, Konstam MP, Mitchison D, Scadding JG, Stott H. A 10-year assessment of a controlled trial comparing debridement and anterior spinal fusion in the management of tuberculosis of the spine in patients on standard chemotherapy in Hong Kong. J Bone Joint Surg. 1982;64:393-8.