Improvement of spinal function in patients with severe kyphosis due to upper thoracic tuberculosis by anterior decompression and fresh-frozen allograft fibular fusion
- VernacularTitle:前路减压及深低温冷冻异体腓骨移植改善上胸段严重结核性后凸畸形患者脊髓功能
- Author:
Junyu HU
;
Yueming SONG
;
Limin LIU
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2007;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
60?) in the Huaxi Hospital of Sichuan University. Three cases aged less than 15 years, but the patients or their relatives were informed of and consented the operation scheme. Without rectification, fusion segments were propped open about 5 mm via the upper and lower fixed vertebra, and anterior one was transplanted with fresh-frozen fibular allograft (offered by the donor corpse and excised extremities due to surgical trauma from the Department of Orthopaedics in Huaxi Hospital. The immunogenicity was greatly reduced by routine defat, acellular procedure, soaking sterilization and deep freezing), while rear one was transplanted with costal bone for supporting graft and filling the graft bone intervals with autogenous bone strips. Gypsum (brace) was used to assist external fixation for 8-10 month postoperation. The complications, graft incorporation, neurological function (Frankel grading scale A-E: complete paralysis-normal or no paralysis), back pain (0-3: none-severe), and mobility score (1-4: lying in bed-needing no assistance) before operation and at final follow-up of each patient were collected for analysis. RESULTS: All the patients were available for follow-ups and the mean period was 3.4 years (1.5-5 years).①Apparent fusion was observed in all cases with no graft fracture, only one patient reported mild graft shift and the kyphosis was unchanged.②There was no worsening of the neurological status in any patient. Frankel grades of 3 adult patients were unchanged after operation. All adolescent patients (n =3) had definite neurological improvement and could walk without assistance, while another was adult patient. Complete relief of back pain was observed in all patients. CONCLUSION: Fresh-frozen allograft fibular is a liable graft material for the treatment of severe kyphosis induced by inactive upper thoracic tuberculosis. Anterior decompression and fusion can promote the recovery of motive function and the alleviation of pain, especially is effective for neurological recovery of adolescent.
