Active thoracic and lumbar spinal tuberculosis in children with kyphotic deformity treated by one-stage posterior instrumentation combined anterior debridement: preliminary study

Abstract

The aim of this study was to retrospectively evaluate the safety, feasibility and efficacy of one-stage posterior instrumentation combined anterior debridement and interbody fusion for treatment of active thoracic and lumbar spinal tuberculosis (TB) in children with kyphotic deformity. A total of 20 children (12 boys, 8 girls) were enrolled in this study from January 2006 to January 2011. All patients underwent one-stage posterior instrumentation combined anterior debridement and interbody fusion. Clinical and radiographic results were analyzed. Patients were followed up for 28.9 months on average. Improvement was shown in all patients with neurologic dysfunction according to American Spinal Injury Association Impairment Scale. The mean preoperative angle of kyphosis was 35.2° ± 6.8° (range 26°-47°), which reduced to 9.7° ± 1.8° (range 6°-13°) postoperatively. The mean angle of kyphosis at the last follow-up was 12.0° ± 1.9° (range 9°-15°). Erythrocyte sedimentation rate and C-reactive protein returned to normal in all patients within 6 months after surgery. All patients acquired bony fusion, and no major complications were observed through the final follow-up visit. One-stage posterior instrumentation combined anterior debridement and fusion were demonstrated to be a safe and effective method to achieve spinal decompression and kyphosis correction in children with thoracic and lumbar spinal TB.