Analysis Of Mid-long-term Efficacy Of Surgical Treatment Of Spinal Tuberculosis In Children

Objective:To investigate the medium and long-term efficacy of surgical treatment of spinal tuberculosis in children; Methods:From february 1999 to June 2011、84 cases of children with spinal tuberculosis were treated by Surgical treatment in the first affiliated hospital of Xinjiang Medical University.Now we retrospectively analyzed their preoperative and postoperative clinical data and follow-up results, Observed the improvement of TB symptoms and nutritional status, the recovery of main neurological symptoms, the recurrence of tuberculosis, kyphosis correction degree and long-term changes,as well as the trunk growth and development of children; Results:84 cases of children with spinal tuberculosis were got long-term follow up,who were treated by surgery. including 36 males,48 females,whose average age was 6.75 years(1-14years). All patiens got follow-up for 3-14 years, average 7.18 years. The average level of ESR was 35.61mm/h before operation,and back to normal level at the final follow-up. There were 62 case of spinal tuberculosis children with kyphotic deformity, The mean Cobb angle was corrected from preoperative 64.8° to postoperative 11.2°, And the mean Cobb angle was 23.4° at the last follow up.55 cases of children had different degree of nerve dysfunction before operation, At the last follow-up,2 cases of preoperative Frankle class A children’s nerve function did not see improvement,3 cases of children’s nerve function improved by 1-3 grade, the rest of the patients were back to normal. incision infection occured in one case,3 cases of children happened incision fistula formation,and the wound healed after debridement. There are 2 cases of postoperative recurrence of tuberculosis, 3 cases of internal fixation loosening or rupture; Conclusion:surgical treatment for pediatric spinal tuberculosis can significantly improve neurological function,correct kyphotic deformity,block the further increase of kyphosis, reconstruct the physiological curvature of the spine, even improve children’s normal growth.Among the surgical methods,one-stage or two-stage posterior combined anterior operation shows the best efficacy in mid-long-term investigation.