20-Year-Follow up of Treatment Using Spine Osteotomy and Halo-pelvic Traction for Tuberculous Kyphosis - A Case Report -

Abstract

A 23-year-old male whose medical history included tuberculous spondylitis presented with a kyphotic deformity and incomplete paraplegia of twenty days duration. Preoperative radiographs demonstrated a T12-L4 kyphotic Cobb's angle of 100 degrees with a complete block showing on the lumbar myelogram at L4-5. The patient underwent anterior osteotomy and release. After the operation, a halo-pelvic apparatus was fit onto the patient, and distraction was begun. After distraction for 2 months, posterior osteotomy and release was performed for final correction, and distraction was maintained for another three weeks. Finally, the kyphotic deformity was corrected to a Cobb's angle of 62 degrees from T12 to L4. Supplementary anterior fusion was done, and the apparatus was removed after consolidation of the fusion mass.Even twenty years after correction of a tuberculous kyphosis, he had no neurological deterioration, and could work as a farmer using agricultural machines. Correction angle and sagittal balance were well maintained.

Keywords: Halo-pelvic traction; Spine osteotomy; Tuberculous kyphosis.

Fig. 1

The patient could not stand without any assistance.

Fig. 2

The halo-pelvic apparatus was fit onto the patient.

Fig. 3

The patient could stand without any assistance.

Fig. 4

Twenty years after the operation, the correction angle was maintained without neurologic symptoms.

Fig. 5

Follow-up MRI twenty years after the operation: There was no spinal canal compression even though the kyphotic deformity remained.