Nonimmobilization of surgically treated tuberculosis of spine in children.

Tuberculosis of the spine is still one of the major health problems in developing countries. The treatment is prolonged and the morbidity considerable. The children are kept off active play for many months. Because of the duration of the disease the treatment is expensive for the class of patients usually afflicted by this disease. The older conservative treatment by chemotherapy, found to be inefficient and inadequate, is now being replaced in most world centres by surgical debridement of the tubercular focus. However, these surgical procedures are usually followed and often preceded by attempts of immobilization by various means such as plaster shells, casts, braces, etc. Postsurgical resumption of activities is usually not allowed for many months. We have observed that a pre and postsurgical immobilization is not required in the strict manner as it is being practices by most clinics today. Our study has shown that gadgets such as plaster casts, etc., have no added advantage and are cumbersome for the patients. They also create a management problem for the family. The fear that neurological complications could develop or that the deformity would increase in severity in the absence of immobilization is not correct. During follow-up examination, patients were evaluated for general and local condition, ESR, local radiograms, neurological status, and the resumption of activities. The increase in the deformity is due to the loss of growth in the particular segment rather than the stress on the spine, which could not be totally prevented anyway by external immobilization.