Late-onset paraplegia is best avoided by correcting severe kyphosis in the active, healing, or healed stages of spinal tuberculosis. We report 16 patients with dorsal or dorsolumbar spinal TB–nine with paraplegia, seven without paraplegia–who underwent kyphus correction. Nine patients had active, five partially treated, and two healed disease. The patients ranged in age from 3 to 38 years and had a mean kyphosis of 58.5 degrees (range, 35 degrees-76 degrees). Mean vertebral body involvement on computed tomography was 4.2 (2-9), and mean initial vertebral body loss was 1.76 (1-2.6). The sequential steps for kyphus correction were anterior corpectomy, shortening of the posterior column, posterior instrumentation and anterior gap grafting, and posterior fusion as a single-stage procedure by the extrapleural anterolateral (costotransversectomy) approach. Minimum followup was 3 months (range, 3-36 months). All but one patient with neural deficit showed complete neural recovery. Mean kyphosis correction was 27.3 degrees (range, 9 degrees-42 degrees). Mean correction loss on 1-year followup was 1.4 degrees (range, 0 degrees-4 degrees)
Keywords : Adolescent,Adult,Child,Child,Preschool,complications,Decompression,Surgical,etiology,Female,Follow-Up Studies,Humans,instrumentation,Kyphosis,Male,Paraplegia,Postoperative Complications,prevention & control,Retrospective Studies,surgery,Treatment Outcome,Tuberculosis,Tuberculosis,Spinal,, Correction,Spinal,Tuberculosis, head and neck pain specialist
Date of Publication : 2007 Jul
Authors : Jain AK;Maheshwari AV;Jena S;
Organisation : Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. dranilkjain@gmail.com
Journal of Publication : Clin Orthop Relat Res
Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/17452923
The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery
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