One-stage Posterior Approach and Combined Interbody and Posterior Fusion for Thoracolumbar Spinal Tu

• 作 者: HONG-QI ZHANG YU-XIANG WANG CHAO-FENG GUO JIN-YANG LIU JIAN-HUANG WU JING CHEN DAI GUO MING-XING TANG
• 机 构: Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South Univer
• 出 处: 第三届全国脊柱结核诊疗新技术研讨会暨2017年湖南省医学会脊柱外科专业委员会年会
• 发表日期: 2017年8期

　　The goal of this study was to determine the efficacy and feasibility of surgical manage-ment of advanced thoracolumbar spine tuberculosis with kyphosis in children in poor general condition with 1-stage posterior decompression,interbody grafts,and posterior instrumentation and fusion.Between 2006 and 2008,7 children with advanced thoracolumbar spinal tuberculosis accompanied by kyphosis and in poor general condition were treated with 1-stage poste-rior decompression,interbody grafts,and posterior instrumentation and fusion followed by chemotherapy.Mean follow-up was 34 months (range,27-42 months).Patients were evaluated pre-and postoperatively for erythrocyte sedimentation rate (ESR),neurological status,pain,spinal canal compromise,and kyphotic angle.Spinal tuberculosis was com-pletely cured and the grafted bones fused in all 7 patients.There was no recurrence of the disease in any patient at final follow-up.In all patients,ESR was normal within 3 months,Frankel neurological classification improved,and pain relief was obtained.Average ca-nal compromise was 52.57% (range,35%-75%) preoperatively and 9.86% (range,0%-19%) postoperatively.Average preoperative kyphosis was 37.9°,which decreased to 5.4° postoperatively.There was no significant loss of correction at last follow-up.Our results show that 1-stage posterior decompression,interbody grafts,and posterior instrumentation and fusion followed by chemotherapy is an alternative treatment for chil-dren with advanced thoracolumbar spinal tuberculosis and in poor general condition.