Abstract
The goal of this study was to assess the efficacy of one-stage surgical management for children with spinal tuberculosis by anterior decompression, bone grafting, posterior instrumentation, and fusion. Between January 2002 and December 2006, 15 cases with spinal tuberculosis were treated with one-stage posterior internal fixation and anterior debridement. All cases were followed-up for an average of 30.3 months (range 12–48 months). The average neurological recovery in the patients was 0.93 grades on the scale of Frankel et al. (Paraplegia 7:179–192, 1969). The average preoperative kyphosis was 36° (range 19–59°), and the average postoperative kyphosis was 23° (range 15–38°) at final follow-up. At final follow-up, minimal progression of kyphosis was seen, with an average kyphosis of 27° (range 16–40°). An average loss of correction of 4° was seen at final follow-up. One-stage surgical management for children with spinal tuberculosis by anterior decompression, bone grafting, posterior instrumentation, and fusion was feasible and effective.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Boachie-Adjei O, Squillante RG (1996) Tuberculosis of the spine. Orthop Clin North Am 27:95–103
Chacko AG, Moorthy RK, Chandy MJ (2004) The transpedicular approach in the management of thoracic spine tuberculosis: a short-term follow up study. Spine 29:363–367
Dai LY, Jiang LS, Wang W et al (2005) Single-stage anterior autogenous bone grafting and instrumentation in the surgical management of spinal tuberculosis. Spine 30:2342–2349
Frankel HL, Hancock DO, Hyslop G et al (1969) The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Paraplegia 7:179–192
Guven O, Kumano K, Yalcin S et al (1994) A single stage posterior and rigid fixation for preventing kyphosis in the treatment of spinal tuberculosis. Spine 19:1039–1043
Hodgson AR, Stock FE (1956) Anterior spinal fusion a preliminary communication on the radical treatment of Pott’s disease and Pott’s paraplegia. Br J Surg 44:266–275
Jain AK (2002) Treatment of tuberculosis of the spine with neurologic complications. Clin Orthop Relat Res 398:75–84
Jain AK (2007) Tuberculosis of the spine. Clin Orthop Relat Res 460:39–49
Jain AK, Aggarwal PK, Arora A et al (2004) Behaviour of the kyphotic angle in spinal tuberculosis. Int Orthop 28:110–114
Kim DJ, Yun YH, Moon SH et al (2004) Posterior instrumentation using compressive laminar hooks and anterior interbody arthrodesis for the treatment of tuberculosis of the lower lumbar spine. Spine 29:275–279
Laheri VJ, Badhe NP, Dewnany GT (2001) Single stage decompression, anterior interbody fusion and posterior instrumentation for tuberculous kyphosis of the dorso-lumbar spine. Spinal Cord 39:429–436
Lönnroth K, Raviglione M (2008) Global epidemiology of tuberculosis: prospects for control. Semin Respir Crit Care Med 29:481–491
Mehta JB, Emery MW, Girish M et al (2003) Atypical Potts disease: localized infection of the thoracic spine due to Mycobacterium avium-intracellulare in a patient without human immunodeficiency virus infection. South Med J 96:685–688
Moon MS (1997) Tuberculosis of the spine. Controversies and a new challenge. Spine 22:1791–1797
Moon MS, Moon YW, Moon JL et al (2002) Conservative treatment of tuberculosis of the lumbar and lumbosacral spine. Clin Orthop Relat Res 398:40–49
Oga M, Arizono T, Takasita M et al (1993) Evaluation of the risk of instrumentation as a foreign body in spinal tuberculosis. Clinical and biologic study. Spine 18:1890–1894
Ozdemir HM, Us AK, Ogun T (2003) The role of anterior spinal instrumentation and allograft fibula for the treatment of Pott disease. Spine 28:474–479
Parthasarathy R, Sriram K, Santha T et al (1999) Short-course chemotherapy for tuberculosis of the spine. J Bone Joint Surg Br 81:464–471
Rajasekaran S (2001) The natural history of post-tubercular kyphosis in children. J Bone Joint Surg Br 83:954–962
Rajasekaran S (2002) The problem of deformity in spinal tuberculosis. Clin Orthop Relat Res 398:85–92
Rajasekaran S, Prasad SA, Dheenadhayalan J et al (2006) Morphological changes during growth in healed childhood spinal tuberculosis. J Pediatr Orthop 26:716–724
Salazar GE, Schmitz TL, Cama R et al (2001) Pulmonary tuberculosis in children in a developing country. Pediatrics 108:448–453
Talu U, Gogus A, Ozturk C et al (2006) The role of posterior instrumentation and fusion after anterior radical debridement and fusion in the surgical treatment of spinal tuberculosis: experience of 127 cases. J Spinal Disord Tech 19:554–559
Teo HE, Peh WC (2004) Skeletal tuberculosis in children. Pediatr Radiol 34:853–860
Tuli SM (2007) Tuberculosis of the spine: a historical review. Clin Orthop Relat Res 460:29–38
Yilmaz C, Selek HY, Gurkan I et al (1999) Anterior instrumentation for the treatment of spinal tuberculosis. J Bone Joint Surg Am 81:1261–1267
Zhang HQ, Guo CF, Xiao XG et al (2007) One-stage surgical management for multilevel tuberculous spondylitis of the upper thoracic region by anterior decompression, strut autografting, posterior instrumentation, and fusion. J Spinal Disord Tech 20:263–267
Zhao J, Lian XF, Hou TS et al (2007) Anterior debridement and bone grafting of spinal tuberculosis with one-stage instrumentation anteriorly or posteriorly. Int Orthop 31:859–863
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Huang, QS., Zheng, C., Hu, Y. et al. One-stage surgical management for children with spinal tuberculosis by anterior decompression and posterior instrumentation. International Orthopaedics (SICOT) 33, 1385–1390 (2009). https://doi.org/10.1007/s00264-009-0758-5
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00264-009-0758-5