GROWTH CHANGES OF SOLIDLY FUSED KYPHOTIC BLOC AFTER SURGERY FOR TUBERCULOSIS - COMPARISON OF 4 PROCEDURES

Citation
Kp. Schulitz et al., GROWTH CHANGES OF SOLIDLY FUSED KYPHOTIC BLOC AFTER SURGERY FOR TUBERCULOSIS - COMPARISON OF 4 PROCEDURES, Spine (Philadelphia, Pa. 1976), 22(10), 1997, pp. 1150-1155
Citations number
19
Categorie Soggetti
Orthopedics,"Clinical Neurology
ISSN journal
03622436
Volume
22
Issue
10
Year of publication
1997
Pages
1150 - 1155
Database
ISI
SICI code
0362-2436(1997)22:10<1150:GCOSFK>2.0.ZU;2-T
Abstract
Study Design. A study to analyze the changes of the spinal deformity d uring the growth period, with regard to different operations for spina l tuberculosis in children. Objectives. To quantify the changes in the kyphotic angle and the growth ratio of the fusion bloc during spinal growth for different fusion techniques. Summary of Background Data. Mo st of the publications dealing with spinal tuberculosis in children fo cused on the clinical outcome with regard to different conservative an d operative treatments. There is little reliable information concernin g the growth of the solidly fused kyphotic bone bloc and its influence on the changes of the kyphotic deformity after different operative pr ocedures. Methods. The study included 117 children operated on for spi nal tuberculosis at the age of 2-6 years at the Ruttonjee Sanatorium i n Hong Kong during the 1950s and 1960s. Lateral radiographs obtained p ostoperatively and 5 and 10 years after the operation were analyzed fo r the growth changes of the solidly fused bone bloc. These results wer e compared with the different operation techniques (e.g., anterior fus ion, posterior fusion, combined anterior and posterior fusion, and ant erior debridement without fusion). Results. The patients treated by an terior fusion showed the worst results with respect to the kyphotic an gle. This was especially true when the lesion was located in the thora cic spine and several segments were involved. Regarding the growth rat io of the fusion bloc, only the combined fusion and the anterior debri dement guaranteed an equal growth of the anterior and posterior height . Conclusions. Radical anterior surgery for spinal tuberculosis destro ys the anterior growth and limits the capacity for spinal remodeling. Therefore, it should be avoided, if it is not absolutely necessary, fo r the healing of the infection or the primary correction of the tuberc ulous deformity.