Surgical management of severe rigid tuberculous kyphosis of dorsolumbar spine.
To assess the effectiveness of deformity correction and safety of the two major corrective spinal surgical procedures, 35 patients, aged 14-47 years, were placed into two groups according to procedures performed. Sixteen patients (group A) had four-stage procedures including initial halo-pelvic distraction after anterior release and a subsequent three procedural steps plus brace. Nineteen patients (group B) had one-set two-stage procedures: wire segmental stabilisation in eight cases and rod/hook and/or pedicle screw stabilisation in 11 cases. Average preoperative kyphosis in group A was 88° and postoperative at zero, three, six, and 18 months were 29˚, 33˚, 35˚ and 35˚, respectively, while those of group B were 86˚ preoperative and postoperative 27˚, 31˚, 33˚, and 33˚, respectively. Neural complication developed in five cases: one in group A and four in group B. It was concluded that the one-set two-stage procedure is more efficient, time-saving, and cost-effective, though it is highly challenging with relatively high rates of neural complication.
Moon
Myung-Sang
MS
Department of Orthopaedic Surgery, Cheju Halla General Hospital, 1963-2, Yeon-dong, Jeju, 690-766, Korea. msmoonos@hotmail.com
Kim
Sung-Soo
SS
Lee
Bong-Jin
BJ
Moon
Jeong-Lim
JL
Moon
Young-Wan
YW
D000293:Adolescent; D000328:Adult; D001863:Bone Screws; D001864:Bone Wires; D001915:Braces; D003362:Cost-Benefit Analysis; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014394:Tuberculosis, Osteoarticular / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult