| Objective: To evaluate the efficacy and safety of posterior osteotomy,anterior debridement and allograft in the treatment of thoracolumbar active spinal tuberculosis in children.Methods: A retrospective analysis of the October 2010-2016 year in June in our hospital underwent posterior osteotomy combined with anterior debridement,37 cases of thoracolumbar spinal tuberculosis in children with bone graft treatment and kyphosis,16 cases were male,21 were female,age 1-14 years,mean age 5.84±3.80 years old.The data of preoperative and postoperative data,follow-up medical records,imaging data and laboratory examination data were collected.The clinical efficacy was measured by measuring the posterior convex angle and the Frankel spinal cord injury classification.The levels of C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),clinical symptoms and the incidence of complications were observed.The fusion rate of bone graft was evaluated by Bridwell grading standard.Results: The follow-up time was 25~45months after operation,with an average of 33.73±5.88 months.The average kyphosis Cobb angle improved from 44.43±10.14 degrees before operation to 14.56±4.03 degrees after operation,and the average correction rate was 77%(P < 0.05).According to the standard of Frankel spinal cord injury classification,the damage of nerve function was improved significantly at the last follow-up,with an average increase of 1.3 levels(P<0.05).2 cases of children had broken rod,1 cases of bone graft displacement,no tuberculosis recurrence.According to the Bridwell grading standard,34 cases of bonegraft fusion reached grade 1,3 patients were grade 2,and the fusion rate of bone graft was92%.Conclusion: For patients with thoracolumbar spinal tuberculosis activity and kyphosis in children by SPO osteotomy and interbody fusion can achieve kyphosis correction,neural functional recovery and reconstruction of the anterior column of the firm,is a safe,simple and effective treatment method. |
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