Radical and débridement surgery for tuberculosis of the spine in children: a preliminary analysis of results from a 17-year prospective study.
We reviewed 80 children (39 male, 41 female) with tuberculosis of the spine, all of whom were subjects of the Medical Research Council Working Party's study in Hong Kong. Forty-seven children were treated with radical surgery and the remaining 33 with débridement surgery. The mean ages at operation for radical surgery and débridement were 7.6 and 5.1 years respectively, and the mean post-operative follow-up was 15.3 and 19.7 years respectively. The clinical and radiological data obtained pre-operatively, 6 months, 1 year and 5 years post-operatively, and at final follow-up were analysed. Neither patients treated with radical nor those treated with débridement surgery had pain or neurological deficit at final follow-up. In the radical surgery group, there was a reduction of the angles of kyphosis and deformity following surgery, which was maintained throughout subsequent follow-up years. However, in the débridement surgical group, there was an increase in the angles of kyphosis and deformity following surgery, which showed a tendency to spontaneous correction in the long term. In this study we did not observe any progressive kyphosis in either group.
Upadhyay
S S
SS
The Duchess of Kent Children's Hospital at Sandy Bay and Department of Orthopaedic Surgery, University of Hong Kong, Hong Kong.
Sell
P
P
Saji
M J
MJ
Leong
J C
JC
D000328:Adult; D000704:Analysis of Variance; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003646:Debridement / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D007738:Kyphosis / Q000209:etiology; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D013131:Spine / Q000601:surgery; D013904:Thoracic Vertebrae / Q000601:surgery*; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000188:drug therapy / Q000601:surgery*
D000995:Antitubercular Agents