Abstract
The rate of bone and joint tuberculosis in elderly patients recently has increased. The treatment for elderly patients especially for tuberculous spondylitis is difficult because many such cases have comorbidities and palsy.
This study compared treatment results for tuberclous spondylitis in elderly (over 70 years old) and younger patients. It also compared the result of operative and non-operative therapies in the elderly patient group.
The authors treated 43 patients from 1992 to 2001, their mean age was 64.4-years (range 24∼90 years). Elderly patient group included 19 cases, in 10 of the 19 cases we operated, and the other 9 cases had no operative therapy. In the non-operative group, many patients had severe complications.
The evaluations were as follows. In the younger group, 12 cases were excellent, 5 cases were good, 3 cases were fair. In the elderly group, 5 cases were excellent (all were in the operative group), 3 cases were good (1 operative case, 2 non-operative cases), 4 cases were fair (1 operative case, 3 non-operative cases), 4 cases were poor (all patints died, 2 operative cases, 2 non-operative cases). In the non-operative group, deformation of vertebral bodies and palsy remained.
Surgical treatment can provide reconstruction of the spinal structure and recovery of palsy. However, surgical treatment carries risk because such patients tend to have many comobidities. To avoid such risk, ideal treatment for these patients is early detection and early chemotherapy.
