title: Thoracolumbar spinal tuberculosis in children with severe post-tubercular kyphotic deformities treated by single-stage closing-opening wedge osteotomy: preliminary report a 4-year follow-up of 12 patients.
abstract: OBJECTIVE
  The correction of severe post-tubercular kyphosis (PTK) is complex and has the disadvantage of being multistaged with a high morbidity. In this study, we evaluated the outcomes of children who underwent single-stage closing-opening wedge osteotomy as a surgical treatment of PTK of the thoracolumbar spine.
  
  
  METHODS
  Our study group included 12 children with thoracolumbar PTK (seven boys and five girls) with an average age of 9.4 years (range 6-12 years), who were treated at our institution from January 2004 to October 2009. The American Spinal Injury Association Impairment Scale and visual analog scale score were used to classify neurologic function. All patients underwent halo-pelvic traction before surgery and were treated with single-stage closing-opening wedge osteotomy.
  
  
  RESULTS
  The duration of surgery averaged 99 min (range 70-150 min). Average blood loss was 782 ml (range 560-1,200 ml), and the average length of hospital stay was 12 days (range 8-16 days). The neurological function of all patients improved significantly after the procedure. The mean preoperative kyphotic angle was 83.3° (range 59-118°), which had reduced to 27.6° (range 20-38°) at the final follow-up visit. All patients had solid fusion, and no major complications were observed through the final follow-up visit.
  
  
  CONCLUSIONS
  Single-stage closing-opening wedge osteotomy is an effective method to correct severe thoracolumbar PTK. A main advantage of the procedure is that it is a posterior-only, single-staged surgery, allowing for significant correction with minimal complications.
authors.affiliation: Department of Spine Surgery, The Xiangya Hospital of Central South University, #87 Xiangya Road, Changsha, Hunan, 410008, People's Republic of China.
authors.forename: Xiaoyang
authors.initials: X
authors.lastname: Pang
authors.forename: Dongzhe
authors.initials: D
authors.lastname: Li
authors.forename: Xiyang
authors.initials: X
authors.lastname: Wang
authors.forename: Xiongjie
authors.initials: X
authors.lastname: Shen
authors.forename: Chengke
authors.initials: C
authors.lastname: Luo
authors.forename: Zhengquan
authors.initials: Z
authors.lastname: Xu
authors.forename: Hao
authors.initials: H
authors.lastname: Zeng
authors.forename: Ping
authors.initials: P
authors.lastname: Wu
authors.forename: Penghui
authors.initials: P
authors.lastname: Zhang
authors.forename: Wei
authors.initials: W
authors.lastname: Peng
mesh_terms: D002648:Child; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000150:complications / Q000601:surgery*; D008137:Longitudinal Studies; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013904:Thoracic Vertebrae / Q000601:surgery; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000150:complications / Q000601:surgery*; D064232:Visual Analog Scale