Halo traction, single-segment circumferential fixation treating cervical tubercular spondylitis with

• 作 者: Hao Zeng Yingfang Liang Xiyang Wang Xiongjie Shen Chengke Luo Zhengquan Xu Zheng Liu Yupeng Zhang
• 机 构: Department of Spine Surgery, the Xiangya Hospital of Central South University, 87＃ Xiangya Road, Cha
• 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
• 关键词: Tubercular spondylitis Kyphosis Single-segment Anterior and posterior approaches

　　Objective: To evaluate the clinical efficacy and feasibility of twenty patients with cervical tubercular spondylitis with kyphosis (CTSK) treated by halo traction,single-segment circumferential instrumented fusion combined anterior debridement,decompression and bone grafting.Methods: Retrospective review of data on twenty patients who suffered from CTSK admitted to our hospital between January 2007 and December 2012.All of them were performed by halo traction,single-segment circumferential instrumented fusion (anterior titanium plate and posterior pedicle or lateral mass fixation) combined anterior debridement,decompression and titanium mesh cage (TMC) filled with allograft bone particles.X-ray and computed tomographic (CT) images were used to determined sagittal balance and bone fusion.The clinical efficacy was evaluated using statistical analysis about the visual analogue scale (VAS) scores of pain,neurological status according to the Frankel classification and erythrocyte sedimentation rate (ESR),which were collected at certain time.Results: The average follow-up period was 34.1 ± 7.0months (24-48 months).In the 20 cases,no obvi-ous postoperative complications related to instrumentation and bone grafting and neurologic function was improved in various degrees.The average pretreatment ESR was 46.4 ± 21.7 mm/h,which got nor-mal within 3 months in all patients.The average VAS on admission was 6.7 ± 1.7,which decreased to 1.6±1.1 postoperatively.All patients got bony fusion within 3.4-5.5 months after surgery.The Cobb angle of 30.8 ±10.5 on admission reduced to 2.9 ± 3.9 performed by preoperative halo traction,became to-5.1 ±4.0 after operation and remained at-4.3 ± 3.8,with 0.9 ±0.7 of correction loss.Conclusions: Halo traction,single-segment circumferential instrumented fusion combined anterior debridement,decompression and TMC can be an effective and safe treatment method for the treat-ment of cervical tubercular spondylitis with kyphosis and the preoperative halo traction should be laid on much emphasis.