Skip to main content
Erschienen in: International Orthopaedics 5/2009

01.10.2009 | Original Paper

One-stage surgical management for children with spinal tuberculosis by anterior decompression and posterior instrumentation

verfasst von: Qi-Shan Huang, Changkun Zheng, Yuezheng Hu, Xiaoling Yin, Huazi Xu, Guoyou Zhang, Qi Wang

Erschienen in: International Orthopaedics | Ausgabe 5/2009

Einloggen, um Zugang zu erhalten

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.
Literatur
1.
Zurück zum Zitat Boachie-Adjei O, Squillante RG (1996) Tuberculosis of the spine. Orthop Clin North Am 27:95–103PubMed Boachie-Adjei O, Squillante RG (1996) Tuberculosis of the spine. Orthop Clin North Am 27:95–103PubMed
2.
Zurück zum Zitat Chacko AG, Moorthy RK, Chandy MJ (2004) The transpedicular approach in the management of thoracic spine tuberculosis: a short-term follow up study. Spine 29:363–367CrossRef Chacko AG, Moorthy RK, Chandy MJ (2004) The transpedicular approach in the management of thoracic spine tuberculosis: a short-term follow up study. Spine 29:363–367CrossRef
3.
Zurück zum Zitat 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 30:2342–2349PubMedCrossRef 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 30:2342–2349PubMedCrossRef
4.
Zurück zum Zitat 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 7:179–192PubMed 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 7:179–192PubMed
5.
Zurück zum Zitat 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 19:1039–1043PubMedCrossRef 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 19:1039–1043PubMedCrossRef
6.
Zurück zum Zitat 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 44:266–275PubMedCrossRef 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 44:266–275PubMedCrossRef
7.
Zurück zum Zitat Jain AK (2002) Treatment of tuberculosis of the spine with neurologic complications. Clin Orthop Relat Res 398:75–84PubMedCrossRef Jain AK (2002) Treatment of tuberculosis of the spine with neurologic complications. Clin Orthop Relat Res 398:75–84PubMedCrossRef
9.
Zurück zum Zitat Jain AK, Aggarwal PK, Arora A et al (2004) Behaviour of the kyphotic angle in spinal tuberculosis. Int Orthop 28:110–114PubMedCrossRef Jain AK, Aggarwal PK, Arora A et al (2004) Behaviour of the kyphotic angle in spinal tuberculosis. Int Orthop 28:110–114PubMedCrossRef
10.
Zurück zum Zitat 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 29:275–279CrossRef 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 29:275–279CrossRef
11.
Zurück zum Zitat 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 39:429–436PubMedCrossRef 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 39:429–436PubMedCrossRef
12.
Zurück zum Zitat Lönnroth K, Raviglione M (2008) Global epidemiology of tuberculosis: prospects for control. Semin Respir Crit Care Med 29:481–491PubMedCrossRef Lönnroth K, Raviglione M (2008) Global epidemiology of tuberculosis: prospects for control. Semin Respir Crit Care Med 29:481–491PubMedCrossRef
13.
Zurück zum Zitat 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 96:685–688PubMedCrossRef 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 96:685–688PubMedCrossRef
14.
Zurück zum Zitat Moon MS (1997) Tuberculosis of the spine. Controversies and a new challenge. Spine 22:1791–1797PubMedCrossRef Moon MS (1997) Tuberculosis of the spine. Controversies and a new challenge. Spine 22:1791–1797PubMedCrossRef
15.
Zurück zum Zitat Moon MS, Moon YW, Moon JL et al (2002) Conservative treatment of tuberculosis of the lumbar and lumbosacral spine. Clin Orthop Relat Res 398:40–49PubMedCrossRef Moon MS, Moon YW, Moon JL et al (2002) Conservative treatment of tuberculosis of the lumbar and lumbosacral spine. Clin Orthop Relat Res 398:40–49PubMedCrossRef
16.
Zurück zum Zitat 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 18:1890–1894PubMed 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 18:1890–1894PubMed
17.
Zurück zum Zitat Ozdemir HM, Us AK, Ogun T (2003) The role of anterior spinal instrumentation and allograft fibula for the treatment of Pott disease. Spine 28:474–479PubMedCrossRef Ozdemir HM, Us AK, Ogun T (2003) The role of anterior spinal instrumentation and allograft fibula for the treatment of Pott disease. Spine 28:474–479PubMedCrossRef
18.
Zurück zum Zitat Parthasarathy R, Sriram K, Santha T et al (1999) Short-course chemotherapy for tuberculosis of the spine. J Bone Joint Surg Br 81:464–471PubMedCrossRef Parthasarathy R, Sriram K, Santha T et al (1999) Short-course chemotherapy for tuberculosis of the spine. J Bone Joint Surg Br 81:464–471PubMedCrossRef
19.
Zurück zum Zitat Rajasekaran S (2001) The natural history of post-tubercular kyphosis in children. J Bone Joint Surg Br 83:954–962PubMedCrossRef Rajasekaran S (2001) The natural history of post-tubercular kyphosis in children. J Bone Joint Surg Br 83:954–962PubMedCrossRef
20.
Zurück zum Zitat Rajasekaran S (2002) The problem of deformity in spinal tuberculosis. Clin Orthop Relat Res 398:85–92PubMedCrossRef Rajasekaran S (2002) The problem of deformity in spinal tuberculosis. Clin Orthop Relat Res 398:85–92PubMedCrossRef
21.
Zurück zum Zitat Rajasekaran S, Prasad SA, Dheenadhayalan J et al (2006) Morphological changes during growth in healed childhood spinal tuberculosis. J Pediatr Orthop 26:716–724PubMed Rajasekaran S, Prasad SA, Dheenadhayalan J et al (2006) Morphological changes during growth in healed childhood spinal tuberculosis. J Pediatr Orthop 26:716–724PubMed
22.
Zurück zum Zitat Salazar GE, Schmitz TL, Cama R et al (2001) Pulmonary tuberculosis in children in a developing country. Pediatrics 108:448–453PubMedCrossRef Salazar GE, Schmitz TL, Cama R et al (2001) Pulmonary tuberculosis in children in a developing country. Pediatrics 108:448–453PubMedCrossRef
23.
Zurück zum Zitat 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 19:554–559PubMedCrossRef 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 19:554–559PubMedCrossRef
24.
25.
Zurück zum Zitat Tuli SM (2007) Tuberculosis of the spine: a historical review. Clin Orthop Relat Res 460:29–38PubMed Tuli SM (2007) Tuberculosis of the spine: a historical review. Clin Orthop Relat Res 460:29–38PubMed
26.
Zurück zum Zitat Yilmaz C, Selek HY, Gurkan I et al (1999) Anterior instrumentation for the treatment of spinal tuberculosis. J Bone Joint Surg Am 81:1261–1267PubMed Yilmaz C, Selek HY, Gurkan I et al (1999) Anterior instrumentation for the treatment of spinal tuberculosis. J Bone Joint Surg Am 81:1261–1267PubMed
27.
Zurück zum Zitat 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 20:263–267PubMedCrossRef 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 20:263–267PubMedCrossRef
28.
Zurück zum Zitat 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 31:859–863PubMedCrossRef 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 31:859–863PubMedCrossRef
Metadaten
Titel
One-stage surgical management for children with spinal tuberculosis by anterior decompression and posterior instrumentation
verfasst von
Qi-Shan Huang
Changkun Zheng
Yuezheng Hu
Xiaoling Yin
Huazi Xu
Guoyou Zhang
Qi Wang
Publikationsdatum
01.10.2009
Verlag
Springer-Verlag
Erschienen in
International Orthopaedics / Ausgabe 5/2009
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-009-0758-5

Weitere Artikel der Ausgabe 5/2009

International Orthopaedics 5/2009 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Klinikreform soll zehntausende Menschenleben retten

15.05.2024 Klinik aktuell Nachrichten

Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

TEP mit Roboterhilfe führt nicht zu größerer Zufriedenheit

15.05.2024 Knie-TEP Nachrichten

Der Einsatz von Operationsrobotern für den Einbau von Totalendoprothesen des Kniegelenks hat die Präzision der Eingriffe erhöht. Für die postoperative Zufriedenheit der Patienten scheint das aber unerheblich zu sein, wie eine Studie zeigt.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.