Kyphosis secondary to infectious disease.

Infections of the spine usually involve the vertebral body and therefore by definition produce a kyphosis. Non-tuberculous infection usually staphylococcal and in the lumbar spine, is often diagnosed late and can involve the cord. Open exploration and stabilization with graft should therefore be considered. The destruction is usually less extensive and therefore the kyphosis less severe than in late neglected tuberculous infections. Tuberculous spinal infection accounts for 59% of all orthopedic tuberculosis. It invariably involves vertebral bodies and is progressive. Destruction of the bodies is by infection and avascular necrosis, kyphosis is inevitable and cord compression a common threat. While L-1 is the most commonly affected body T-10 is statistically the most commonly associated with cord compression. The treatment of spinal tuberculosis should be aimed at correcting 5 basic defects associated with the disease and the deformity: mechanical instability; chronic smoldering infection; spinal cord and nerve root compression; disturbance of spinal growth; depressed lung function. The cornerstone to effective treatment for spinal tuberculosis is drug therapy and the anterior fusion operation. For the established tuberculous kyphosis, which is always a fixed deformity, multiple staged operations and gradual correction used the Halo-pelvic apparatus is the best treatment available at present.