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一期后路内固定联合前路清创治疗儿童伴有后凸畸形的活动期胸腰椎脊柱结核:初步研究

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

作者信息

Hu Jianzhong, Li Dongzhe, Kang Yijun, Pang Xiaoyang, Wu Tianding, Duan Chunyue, Cao Yong

机构信息

Department of Spine Surgery, Xiangya Hospital, Central South University, 87# Xiangya Road, Changsha, 410008, Hunan, People's Republic of China,

出版信息

Eur J Orthop Surg Traumatol. 2014 Jul;24 Suppl 1:S221-9. doi: 10.1007/s00590-014-1440-1. Epub 2014 Apr 4.

DOI:10.1007/s00590-014-1440-1
PMID:24700338
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.

摘要

本研究的目的是回顾性评估一期后路内固定联合前路清创及椎间融合术治疗伴有后凸畸形的儿童活动性胸腰椎脊柱结核(TB)的安全性、可行性和有效性。2006年1月至2011年1月,共有20名儿童(12名男孩,8名女孩)纳入本研究。所有患者均接受了一期后路内固定联合前路清创及椎间融合术。分析临床和影像学结果。患者平均随访28.9个月。根据美国脊髓损伤协会损伤量表,所有神经功能障碍患者均有改善。术前平均后凸角为35.2°±6.8°(范围26°-47°),术后降至9.7°±1.8°(范围6°-13°)。末次随访时平均后凸角为12.0°±1.9°(范围9°-15°)。所有患者术后6个月内红细胞沉降率和C反应蛋白均恢复正常。所有患者均获得骨融合,末次随访时未观察到重大并发症。一期后路内固定联合前路清创及融合术被证明是一种安全有效的方法,可实现胸腰椎脊柱结核患儿的脊髓减压和后凸畸形矫正。

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