Combined anterior and posterior fusion for spine TB in children

In this study, anterior debridement, grafting and posterior pedicular plating with small DCP with cortical screws 3.5 mm were used in 12 children with tuberculosis of the dorsal and dorsolumbar spine. All of them were in different grades of paraplegia. The affected level was D6-7 in 3 patients, D8-9 in 3 patients, D12-L1 in 5 patients and L2-3 in 1 child. The patients were operated upon anteriorly by thoracotomy in six patients and thoracolumbar approach in the remaining six cases. A second posterior step was done one week later. Postoperative plaster jacket was done for four months at least. A follow up was done for each patient at 1.5, 3, 6 and 12 months including clinical and radiological assessment. The follow up duration ranged from 1-3 years with an average of 18 months. There was fusion for all patients after 4-6 months. A neurological improvement was reported for all patients [2 Frankel grades at least]. Kyphotic deformity was corrected from 33 to 10 degree postoperatively and increased to 18 degree on the late follow up. Antituberculous drugs were continued for nine months at least according to the recommended doses