J Bone Joint Surg Br
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J Bone Joint Surg Br · Sep 2001
Multicenter StudyThe natural history of post-tubercular kyphosis in children. Radiological signs which predict late increase in deformity.
The progression of post-tubercular kyphosis in 61 children who received ambulatory chemotherapy was studied prospectively. The angles of deformity and kyphosis were measured for each patient at diagnosis, 3, 6, 9, 12 and 18 months later and every year thereafter for 15 years. During the course of the disease signs of instability appeared on the radiographs of some of the children. ⋯ Multiple regression analysis showed that a spinal instability score of more than 2 was a reliable predictor of patients with an increase of more than 30 degrees in deformity and a final deformity of over 60 degrees. Since signs of radiological instability appear early in the disease, they can be reliably used to identify children whose spine is at risk for late progressive collapse. Surgery is advised in these cases.