Kyphus correction in spinal tuberculosis.
Late-onset paraplegia is best avoided by correcting severe kyphosis in the active, healing, or healed stages of spinal tuberculosis. We report 16 patients with dorsal or dorsolumbar spinal TB--nine with paraplegia, seven without paraplegia--who underwent kyphus correction. Nine patients had active, five partially treated, and two healed disease. The patients ranged in age from 3 to 38 years and had a mean kyphosis of 58.5 degrees (range, 35 degrees-76 degrees). Mean vertebral body involvement on computed tomography was 4.2 (2-9), and mean initial vertebral body loss was 1.76 (1-2.6). The sequential steps for kyphus correction were anterior corpectomy, shortening of the posterior column, posterior instrumentation and anterior gap grafting, and posterior fusion as a single-stage procedure by the extrapleural anterolateral (costotransversectomy) approach. Minimum followup was 3 months (range, 3-36 months). All but one patient with neural deficit showed complete neural recovery. Mean kyphosis correction was 27.3 degrees (range, 9 degrees-42 degrees). Mean correction loss on 1-year followup was 1.4 degrees (range, 0 degrees-4 degrees).
Jain
Anil K
AK
Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. dranilkjain@gmail.com
Maheshwari
Aditya V
AV
Jena
Santosh
S
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D010264:Paraplegia / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000150:complications / Q000601:surgery*