Prognosis of Primary Spinal Tuberculosis by Treatment of Antituberculosis Drugs, Surgery, and Rehabilitation Program: A Case Series

Gustin Fat’aah Muhayani, Subagyo

2017

Abstract

Introduction: In a study from an endemic country, the majority of spinal tuberculosis patients had severe motor and sensory impairment. All patients were managed using anti tuberculosis drugs and some of them required operative treatment as well. Clinical improvement was seen 70% patients within 6 months of treatment.Material and Methods : These are case series study from Physical Medicine and Rehabilitation Department, Soetomo Hospital, Surabaya. We followed up 3 patients with primary spinal tuberculosis that undergoing the anti tuberculosis drugs since 1 month before debridement and stabilization surgery, and also got thoracolumbosacral orthosis flexion extension lateral (TLSO FEL) control with several rehabilitation program includes ROM exercise, breathing exercise, endurance exercise, strengthening exercise, and sensory reeducation. They also get electrical stimulation for improved of the strength muscles and some of them get electrical stimulation at parasacral and tibialis posterior. This rehabilitation program was routinely performed 2x/week at Soetomo Hospital and we educate to continue at home. We evaluate the improvement of functional staging by Barthel Index (BI) and Spinal Cord Injury (SCI) Staging by Asia Impairment Scale (AIS) after 6 months rehabilitation program post surgery. Result : After 6 months, first patient was female, 32 years old with Thoracal XII Paraplegia AIS C and BI 20 was improved to BI 95 and the SCI staging to AIS D. Second patient was male, 32 years old with Thoracal IX Paraplegia AIS C with BI 50 was improved to BI 85 and SCI Staging to AIS D. And the third patient was male, 32 years old with Thoracal VI Paraplegia AIS B with BI 25 was improved to BI 80 and SCI staging to AIS D. Discussion : These 3 patients was primary spinal tuberculosis with the first symptom was back pain that getting worsen and had neurological impairment in 6-12 months later. They diagnosed spinal tuberculosis when neurological impairment was found. Using anti tuberculosis drugs soon followed with surgery and comprehensive rehabilitation program helps to improved functional and spinal cord injury staging. Conclusion : Combination anti tuberculosis drugs, debridement - stabilization surgery, and comprehensive rehabilitation program could give good prognosis for young primary spinal tuberculosis patients.

Paper Citation

in Harvard Style

Muhayani G. and Subagyo. (2017). Prognosis of Primary Spinal Tuberculosis by Treatment of Antituberculosis Drugs, Surgery, and Rehabilitation Program: A Case Series.In Proceedings of the International Meeting on Regenerative Medicine - Volume 1: IMRM, ISBN 978-989-758-334-6, pages 306-310. DOI: 10.5220/0007320703060310

in Bibtex Style

@conference{imrm17,
author={Gustin Fat’aah Muhayani and Subagyo},
title={Prognosis of Primary Spinal Tuberculosis by Treatment of Antituberculosis Drugs, Surgery, and Rehabilitation Program: A Case Series},
booktitle={Proceedings of the International Meeting on Regenerative Medicine - Volume 1: IMRM,},
year={2017},
pages={306-310},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0007320703060310},
isbn={978-989-758-334-6},
}

in EndNote Style

TY - CONF

JO - Proceedings of the International Meeting on Regenerative Medicine - Volume 1: IMRM,
TI - Prognosis of Primary Spinal Tuberculosis by Treatment of Antituberculosis Drugs, Surgery, and Rehabilitation Program: A Case Series
SN - 978-989-758-334-6
AU - Muhayani G.
AU - Subagyo.
PY - 2017
SP - 306
EP - 310
DO - 10.5220/0007320703060310