Clinical efficacy of posterior approach to surgical treatment for thoracic and lumbar tuberculosis in children

Abstract

Objective To investigate the clinical efficacy of posterior surgery for children with thoracic and lumbar tuberculosis. Methods Clinical data of 9 children with vertebral tuberculosis who underwent posterior surgery in our department from January 2013 to June 2021 were collected and retrospectively analyzed. The operation time, blood loss, length of hospital stay and other indicators, as well as the general condition after operation and during follow-up were summarized and analyzed. Kyphosis correction was evaluated with the results of X-ray filming and CT scanning. Visual analogue score (VAS), Oswestry disability index (ODI) and Frankel scores were used to evaluate the recovery of neurological function. Results For the 9 children, there were 5 males and 4 females, at a mean age of 6.4±3.3 years, and there were 4 cases of thoracic, 2 of thoracolumbar and 3 of lumbar tuberculosis. Preoperative Frankel scores showed that there were 2 cases in Grade C, 3 in Grade D, and 4 in Grade E for neural status. The mean follow-up time was 29.2±8.6 months. All patients had attained neurological improvements with Frankel grade increasing by more than 1 grade. At the final follow-up, the VAS score decreased from 3.2±2.0 to 1.0±0.5, while ODI score from 31.3±21.3 to 13.7±8.7. The Cobb angle of kyphosis was decreased from (46.2±23.8)° preoperatively to (22.6±16.9)° postoperatively. All patients achieved satisfactory osseous fusion in 1 year after surgery. Only 1 patient had tuberculosis recurrence and received a second operation. The mean operation time was 398.2±203.7 min, mean blood loss was 550.0±355.3 mL, and mean hospital stay was 20.0±8.4 d. Conclusion Posterior approach can achieve satisfactory outcomes and avoid the occurrence of kyphosis in the treatment of thoracic and lumbar tuberculosis in children.

Keywords

• pediatric spinal tuberculosis
• posterior approach
• kyphosis