Anterior spinal decompression in HIV-positive patients with tuberculosis

Description: A PROSPECTIVE STUDY S. Govender, A. H. Parbhoo, K. P. S. Kumar, K. Annamalai From the Department of Orthopaedic Surgery, University of Natal, South Africa
A total of 39 HIV-infected adults with spinal tuberculosis underwent anterior spinal decompression for neurological deficit. Fresh-frozen allografts were used in 38 patients. Antituberculous drugs were prescribed for 18 months, but antiretroviral therapy was not used. Six patients died within two years of surgery. Neurological recovery and allograft incorporation were observed at follow-up at a mean of 38 months, although the CD4/CD8 ratios were reversed in all patients. Adequate preoperative nutritional support and compliance with antituberculous treatment are essential in ensuring a satisfactory outcome. J Bone Joint Surg [Br] 2001;83-B:864-7.