[One stage posterior vertebral column resection for the treatment of thorciclumbar tuberculosis with kyphotic deformity].
OBJECTIVE
To evaluate the clinical outcome of one stage posterior vertebral column resection in patients with spinal tuberculosis combined with kyphotic deformity.


METHODS
Thirty-six patients with spinal tuberculosis combined with kyphotic deformity underwent posterior one-stage vertebral column resection reducing tension on the spinal cord from 1998 to 2006. The patients were mobilized with a thoracolumbar orthosis for 3 months. All patients had a minimum of a 2-year follow-up, and clinical examinations and radiographs were obtained at 6-month intervals.


RESULTS
No perioperative mortality occurred. The average duration of surgery was 208 (145 approximately 385) min. The kyphotic Cobb angle improved from the preoperative average of 57.2 degree(17 degree approximately 86 degree) to a postoperative average of 8.9 degree(-6 degree approximately 27 degree). The average horizontal distance between C(7) and S(1) was 13.6 (8 approximately 19) mm preoperatively and 3.6 (-11 approximately 9) mm postoperatively. Nineteen patients had preoperative neurological deficits. Of them, 89.5% (17/19) showed a postoperative neurologic improvement. Perioperative complications occurred in 3(8.5%) of the 36 patients with pneumonias and superficial infections. Twenty-five patients (69.4%) showed radiographic evidence of solid fusion in the follow-up examinations. In the follow-up, 25% (9/36) patients rated their results as excellent, 66.7% (24/36) as good, 2 as fair, and 1 as poor.


CONCLUSIONS
One stage posterior vertebral column resection for the treatment of spinal tuberculosis with kyphotic deformity is safe and effective. Because this procedure is highly technical, the surgeon must be familiar with the pathoanatomy and the operation must be carefully done.
Deng
You-wen
YW
Department of Spine Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China. drywdeng@yahoo.com.cn
Lu
Guo-hua
GH
Wang
Bing
B
Kang
Yi-jun
YJ
Li
Jing
J
Liu
Wei-dong
WD
Chen
Fei
F
Ma
Ze-min
ZM
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D010027:Osteotomy / Q000379:methods; D013131:Spine / Q000601:surgery; D013904:Thoracic Vertebrae / Q000601:surgery*; D014399:Tuberculosis, Spinal / Q000150:complications / Q000601:surgery*