Clinical symptoms of spinal tuberculosis in children and the effect of surgical treatment
10.3760/cma.j.issn.1008-6706.2019.10.019
- VernacularTitle: 小儿脊柱结核60例临床症状分析及手术治疗的效果观察
- Author:
Hongyi ZHANG
1
;
Chen CHEN
;
Qiang LI
Author Information
1. Department of Orthopedics, Shanxi Dayi Hospital, Taiyuan, Shanxi 030001, China
- Publication Type:Journal Article
- Keywords:
Tuberculosis, spinal;
Pain;
Disease attributes;
Surgical procedures, operative;
Treatmert outcome;
Child
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(10):1229-1232
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical symptoms of spinal tuberculosis in children and the effect of surgical treatment.
Methods:From October 2012 to October 2017, 60 cases of spinal tuberculosis admitted to Shanxi Dayi Hospital were selected, including 31 male children and 29 female children.The age of the children was (7.92±2.93)years old; 4 children with cervical vertebra lesions, 3 children with cervical thoracic junction lesions, 23 children with thoracic vertebra lesions, 28 children with lumbar vertebra lesions, and 2 children with lumbar sacral vertebra lesions.There were 27 children with neurological damage.Among them, 2 children with Frankel classification of A, 4 children with B, 7 children with C, and 14 children with D. All children were treated by surgery, and standing full spine X-rays were taken before and after operation.The sagittal deviation distance and sagittal Cobb angle of the children's trunk were measured, and spinal fusion and fixation of all children were recorded.
Results:In 52 cases (86.67%), the main symptoms were pain or radiation pain, 45 cases (75.00%) showed local palpable mass, and 7 cases (11.67%) had palpable paraspinal or abdominal mass.There were 37 cases (61.67%) with kyphosis and different degrees of spinal bulge, 11 cases (18.33%) showed abnormal sensation and limb numbness.There were 11 cases (18.33%) with walking difficulty.All 60 cases of spinal tuberculosis had abnormal X-ray manifestations.There were abnormal physiological curvature or kyphosis in the diseased area of children, the intervertebral space of children became narrow, and the edge of vertebral body was blurred, there were widening, flattening or wedge-like changes.The operative time was (184.29±23.28)min, and the intraoperative bleeding was (475.39±30.28)mL.The fusion fixation segment was (10.27±1.92) and the sagittal plane was (10.27±1.92). Cobb angle was 106.7°, postoperative correction was 31.3°, the correction rate was 76.21%, the mean preoperative correction of thoracic kyphosis was 76.7°, postoperative correction was 15.7 °, the average correction was 55.9°, the mean sagittal deviation distance of trunk was -15.42 mm, postoperative correction was 0.63 mm, and the average correction was 20.68 mm.
Conclusion:Pain is the first symptom of spinal tuberculosis in children, most of them will be complicated with severe kyphosis.Surgical treatment of children with spinal tuberculosis can get better clinical results, and it is worthy of popularizing in clinic.The choice of surgical approach and fusion range is the key to the treatment process.
