Hu Xiongke, Zhang Hongqi, Yin Xinhua, Chen Yong, Yu Honggui, Zhou Zhenhai
Department of Spine Surgery, Xiangya Hospital of Central South University, Changsha, 410008, China.
Childs Nerv Syst. 2016 Mar;32(3):535-9. doi: 10.1007/s00381-015-2948-3. Epub 2015 Nov 2.
The purpose of this study is to investigate the clinical efficacy and feasibility of one-stage posterior focus debridement, fusion, and instrumentation in the surgical treatment of lumbar spinal tuberculosis with kyphosis in children.
From December 2007 to May 2012, 13 patients (six males and seven females) suffering from lumbar spinal tuberculosis with kyphosis were admitted. All patients were treated with one-stage posterior focus debridement, fusion, and instrumentation. Then, the clinical efficacy was estimated by statistical analysis based on the data about Frankel grade, the Cobb angle of kyphosis, and erythrocyte sedimentation rate (ESR), which were collected at certain time.
The age of all patients ranged from 5 to 13 years (average, 8.8 years). Operation time ranged from 120 to 190 min (average, 165 min). Intraoperative blood loss ranged from 200 to 800 ml (average, 460 ml). All patients were followed up for 24 to 57 months postoperatively (average, 33.5 months). The Cobb angle was changed significantly between preoperation and postoperation (P < 0.05), and there was no significant loss at the last follow-up. The preoperation ESR (62.5 ± 15.7) returned to normal (16.6 ± 8.1) within 3 months postoperatively in all patients (P < 0.05). Bone fusion was achieved within 3-5 months (average, 3.5 months). In the 13 cases, no postoperative severe complications occurred and neurologic function improved in various degrees.
The outcomes of follow-up showed that one-stage posterior focus debridement, fusion, and instrumentation can be an effective treatment method for the lumbar spinal tuberculosis with kyphosis in children.
本研究旨在探讨一期后路病灶清除、融合及内固定术治疗儿童腰椎结核伴后凸畸形的临床疗效及可行性。
2007年12月至2012年5月，收治13例腰椎结核伴后凸畸形患者（男6例，女7例）。所有患者均接受一期后路病灶清除、融合及内固定术。然后，根据特定时间收集的Frankel分级、后凸Cobb角和红细胞沉降率（ESR）数据进行统计分析，评估临床疗效。
所有患者年龄5至13岁（平均8.8岁）。手术时间120至190分钟（平均165分钟）。术中出血量200至800毫升（平均460毫升）。所有患者术后随访24至57个月（平均33.5个月）。术前与术后Cobb角变化有统计学意义（P < 0.05），末次随访时无明显丢失。所有患者术后3个月内术前ESR（62.5±15.7）恢复正常（16.6±8.1）（P < 0.05）。3至5个月（平均3.5个月）实现骨融合。13例患者术后均未发生严重并发症，神经功能均有不同程度改善。
随访结果表明，一期后路病灶清除、融合及内固定术可作为儿童腰椎结核伴后凸畸形的有效治疗方法。
