Background:
Spinal tuberculosis may result in severe kyphotic deformity. Effective restoration of lordosis and correction of sagittal balance often requires invasive osteotomies associated with significant morbidity. The advantages of focusing on symptomatic management and staging in the initial treatment of these deformities have not been well reported to date.
Observations:
The authors reported the case of a 64-year-old Vietnamese woman with a history of spinal tuberculosis who underwent anterior lumbar interbody fusion (ALIF) for symptomatic treatment of L5-S1 radiculopathy resulting from fixed kyphotic deformity. Postoperatively, the patient experienced near immediate symptom improvement, and radiographic evidence at 1-year follow-up showed continued lordotic correction of 30° as well as stable sagittal balance.
Lessons:
In this case, an L5-S1 ALIF was sufficient to treat the patient’s acute symptoms and provided satisfactory correction of a tuberculosis-associated fixed kyphotic deformity while effectively delaying more invasive measures, such as a vertebral column resection. Patients with adult spinal deformity may benefit from less invasive staging procedures before treating these deformities with larger surgeries.
Keywords:
ALIF = anterior lumbar interbody fusion; ALL = anterior longitudinal ligament; ASD = adult spinal deformity; CT = computed tomography; DVT = deep vein thrombosis; LL = lumbar lordosis; LLIF-ACR = lateral lumbar interbody fusion with anterior column realignment; MRI = magnetic resonance imaging; Mycobacterium tuberculosis; PI = pelvic incidence; PLL = posterior longitudinal ligament; PSO = pedicle subtraction osteotomy; PT = pelvic tilt; Pott’s disease; SVA = sagittal vertical axis; VCR = vertebral column resection; adult spinal deformity; anterior lumbar interbody fusion; spinal tuberculosis.