One-stage surgery combined posterior and anterior approach for thoracolumbar tuberculosis in children / 实用医学杂志

ABSTRACT

Objective To explore the clinical application of one-stage surgery combined posterior inter-fix-ation and anterior debridement for thoracolumbar tuberculosis in children. Methods The clinical data of thoraco-lumbar tuberculosis in children treated by combined surgery of posterior and anterior approach from January 2006 to December 2014 was reviewed retrospectively. The enrolled patients were divided into group A(25 patients under-went one-stage surgery)and group B(16 patients underwent two-stage surgery). Operation time,blood loss and complications were compared. The clinical effectiveness was evaluated by using visual analogue scale(VAS), kyphotic angle,neurological function(ASIA)and bone fusion. Results All operations completed successfully. There was statistically significance between two groups regarding to operation time [(202 ± 50)min vs. (254 ± 46)min]and blood loss[(332 ± 162)mL vs.(432 ± 106)mL]. The follow-up of 12 ~ 60 months indicated that bone grafts were fused without instrumentation failure. For patients with spinal cord injury ,there was 1 or 2 grades improvement by ASIA grading. VAS and the kyphotic angle were improved after operation ,but there was no statisti-cally significance between two groups regarding to the efficiency. Conclusions One-stage surgery combined pos-terior and anterior approach is a safe and effective method for thoracolumbar tuberculosis in children for immediate stability of spine,less blood loss and shorter operation time.