Medical management of XXXX in the thoracic and lumbar spine: a prospective clinical study.

@entity1 @entity1513 @entity3083 @entity51 @entity1745 @entity85 @entity614
OBJECT: The aim of this study was to evaluate conservative medical management of 44 @entity1 with @entity3083 . The prognostic significance of various clinical, radiological, and long-term follow-up findings in these @entity1 was also evaluated. METHODS: Between January 1990 and January 2005 data were collected prospectively at the authors' clinic in 44 @entity1 with @entity3083 in the thoracic or lumbar spine. These @entity1 had no major @entity51 or severe @entity85 . The study population consisted of 21 male (48%) and 23 female (52%) @entity1 , with a mean age of 42.1 years (range 10-70 years). The most common region of @entity3083 was the thoracolumbar junction (18 cases; 41%), followed by the thoracic (16 cases; 36%) and lumbar (10 cases; 23%) regions. All @entity1 presented with abscesses. With the exception of two cases, all had kyphotic angles smaller than 30 degrees. At presentation, 20 @entity1 had neurological signs of @entity1745 during clinical examination. Both clinical and biopsy findings were used in all cases for diagnosis. A diagnosis was confirmed by a positive biopsy specimen culture in 19 (43.2%) of 44 cases, and histopathological findings were compatible with the results of these cultures in all cases. All @entity1 were treated with antituberculous chemotherapy, and the diseases in only two (4.5%) was resistant to the regimen. An independent observer assessed the clinical and imaging findings after a mean follow-up duration of 40 months. Forty-two (95.4%) of the 44 @entity1 were successfully treated with conservative medical management and attained acceptable spinal deformity angles, and none of these @entity1 had any residual instability, @entity614 , or neurological compromise. Only 4.5% of the @entity1 experienced residual @entity85 (as much as a 30 degrees kyphotic angle), which was clinically obvious but biomechanically stable. CONCLUSIONS: @entity1 with @entity3083 in the lumbar or thoracic region, without @entity51 or @entity1513 , can be treated conservatively in the vast majority of cases. Indications for surgery need to be redefined given these new data.
