1.Selective of different surgical procedure in treatment of thoracic and lumbar spine tuberculosis with severe kyphosis and paraplegia
Hao WANG ; Julaiti TAYIERJIANG ; Hong YUAN
Orthopedic Journal of China 2006;0(11):-
[Objective]To evaluate the clinical results of the patients with severe kyphosis and paraplegia in differnt spine segment due to tuberculosis of thoracic and lumbar which had been treated by different surgical procedure. [Methods]There were a total of 23 patients, 16 male and 7 female in this stuady. The average age were 25 years, ranging from 12~56 years old. Tuberculosis lesion were located in different spine segment(T1~4)four cases, (T5~10)four cases, (T11~L2) nine cases,(L3~5) six cases, two vertebral bodies were involved in 8 patients and three vertebralbodies involved in 12 patients. Surgical procedure:four patients treated through modified anterior cervico-thoracic approach.Five patients treated through one stageposterior total vertebral osteotomy, other patients combined with anterior-posterior approach, according to the patient's surgical situation, twelve patients accepted anterior and posterior combined operation, two patients were treated by two stages.The period of bone grafting fusion, kyphosis deformity correction degree ,and neurological function recovery record were investigated postoperatively.[Results]All patients got solid fusion in a average of seven months. The kyphosis deformity was corrected 49? in average, which was maintained well within follow-up period. Patients neurological function deficiency achieved completely recovery, the longest time being within 10 months. All patients were cured thoroughly and there was no seroius complication.[Conclusion]Different surgical procedure should be selected, according to different spine segments due to tuberculosis of thoracic and lumbar vertebrae with the extent of severe kyphosis and paraplegia, it can achieve thoroughly debridement of tubereulosis, solid interbody fusion, good correction of deformity and forever stability of spine with anterior or posterior internal fixation.It could get successful rehablitation for patient’s neurological function and improve the patient’s life quality.