Surgical management of severe rigid tuberculous kyphosis of dorsolumbar spine

Int Orthop. 2011 Jan;35(1):75-81. doi: 10.1007/s00264-010-0999-3. Epub 2010 Mar 29.

Abstract

To assess the effectiveness of deformity correction and safety of the two major corrective spinal surgical procedures, 35 patients, aged 14-47 years, were placed into two groups according to procedures performed. Sixteen patients (group A) had four-stage procedures including initial halo-pelvic distraction after anterior release and a subsequent three procedural steps plus brace. Nineteen patients (group B) had one-set two-stage procedures: wire segmental stabilisation in eight cases and rod/hook and/or pedicle screw stabilisation in 11 cases. Average preoperative kyphosis in group A was 88° and postoperative at zero, three, six, and 18 months were 29˚, 33˚, 35˚ and 35˚, respectively, while those of group B were 86˚ preoperative and postoperative 27˚, 31˚, 33˚, and 33˚, respectively. Neural complication developed in five cases: one in group A and four in group B. It was concluded that the one-set two-stage procedure is more efficient, time-saving, and cost-effective, though it is highly challenging with relatively high rates of neural complication.

MeSH terms

  • Adolescent
  • Adult
  • Bone Screws
  • Bone Wires
  • Braces
  • Cost-Benefit Analysis
  • Humans
  • Kyphosis / diagnostic imaging
  • Kyphosis / surgery*
  • Middle Aged
  • Orthopedic Procedures / economics
  • Orthopedic Procedures / instrumentation
  • Orthopedic Procedures / methods*
  • Radiography
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Tuberculosis, Osteoarticular / diagnostic imaging
  • Tuberculosis, Osteoarticular / surgery*
  • Young Adult