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 13) 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 0.77degrees, 24.3degrees and 31.75degrees respectively, with a mean increase in angle of 7.4degrees. In group B, the readings were 0.67, 25.9degrees and 26.8degrees respectively, with a mean increase in angle of 0.9degrees. Kyphotic deformity continued to progress until 2 years' follow-up. Progression was more pronounced in the non-operative group.