title: Tubercular spondylitis in children.
abstract: Spine of the child has unique anatomy and growth potential to grow to adult size. Tuberculosis (TB) spine results in bone loss as well as disturbed growth potential, hence spinal deformities may progress as the child grows. The growth potential is also disturbed when the disease focus is surgically intervened. Surgery is indicated for complications such as deformity, neurological deficit, instability, huge abscess, diagnostic dilemma and in suspected drug resistance to mycobacterium tuberculosis. The child on antitubercular treatment needs to be periodically evaluated for weight gain and drug dosages need to be adjusted accordingly. The severe progressive kyphotic deformity should be surgically corrected. Mild to moderate cases should be followed up until maturity to observe progression/improvement of spinal deformity. The surgical correction of kyphotic deformity in active disease is less hazardous than in a healed kyphosis. The internal kyphectomy by extra pleural approach allows adequate removal of internal salient in paraplegic patients with healed kyphotic deformity.
authors.affiliation: Department of Orthopaedics, University College of Medical Sciences and GTB Hospital, New Delhi, India.
authors.forename: Anil K
authors.initials: AK
authors.lastname: Jain
authors.affiliation: Department of Orthopaedics, University College of Medical Sciences and GTB Hospital, New Delhi, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Sreenivasan
authors.affiliation: Department of Orthopaedics, University College of Medical Sciences and GTB Hospital, New Delhi, India.
authors.forename: R
authors.initials: R
authors.lastname: Mukunth
authors.affiliation: Department of Orthopaedics, University College of Medical Sciences and GTB Hospital, New Delhi, India.
authors.forename: Ish Kumar
authors.initials: IK
authors.lastname: Dhammi
keywords: Kyphus correction; osteoarticular tuberculosis; pediatric tuberculosis; tuberculosis of spine
references.citation: Spinal Cord. 2001 Aug;39(8):429-36
references.pmid: 11512073
references.citation: J Bone Joint Surg Am. 1994 May;76(5):701-8
references.pmid: 8175818
references.citation: Clin Orthop Relat Res. 2007 Jul;460:124-9
references.pmid: 17438475
references.citation: J Bone Joint Surg Br. 2006 Jul;88(7):925-7
references.pmid: 16798997
references.citation: Spine (Phila Pa 1976). 1997 May 15;22(10):1150-5
references.pmid: 9160475
references.citation: J Bone Joint Surg Br. 1973 Nov;55(4):678-97
references.pmid: 4203202
references.citation: Spine (Phila Pa 1976). 1996 Aug 1;21(15):1840-1
references.pmid: 8855474
references.citation: Acta Orthop Belg. 1990;56(1 Pt A):111-4
references.pmid: 2200228
references.citation: J Bone Joint Surg Br. 1985 Jan;67(1):103-10
references.pmid: 2857181
references.citation: Neurosurgery. 2011 May;68(5):E1485-90; discussion E1490
references.pmid: 21307787
references.citation: Med Princ Pract. 2003 Apr-Jun;12(2):92-6
references.pmid: 12634463
references.citation: Indian J Orthop. 2010 Apr;44(2):127-36
references.pmid: 20418999
references.citation: Clin Orthop Relat Res. 2007 Jul;460:39-49
references.pmid: 17438468
references.citation: Clin Orthop Relat Res. 2007 Jul;460:2-3
references.pmid: 17620802
references.citation: J Spinal Disord Tech. 2006 Dec;19(8):595-602
references.pmid: 17146304
references.citation: J Bone Joint Surg Am. 2002 Oct;84(10):1842-8
references.pmid: 12377917
references.citation: J Spinal Disord Tech. 2008 Oct;21(7):484-8
references.pmid: 18836359
references.citation: Spine (Phila Pa 1976). 1997 Aug 1;22(15):1791-7
references.pmid: 9259793
references.citation: Eur Spine J. 2010 Apr;19(4):583-92
references.pmid: 20013004
references.citation: Spine (Phila Pa 1976). 1996 Oct 15;21(20):2356-62
references.pmid: 8915071
references.citation: J Bone Joint Surg Br. 2001 Sep;83(7):954-62
references.pmid: 11603534
references.citation: Br J Surg. 1974 Nov;61(11):853-66
references.pmid: 4611574
references.citation: Indian Pediatr. 2008 Oct;45(10):852-4
references.pmid: 18948658
references.citation: J Bone Joint Surg Am. 2007 Feb;89 Suppl 1:8-13
references.pmid: 17272418
references.citation: J Bone Joint Surg Am. 1974 Oct;56(7):1419-34
references.pmid: 4447671
references.citation: Spine (Phila Pa 1976). 1994 May 1;19(9):1039-43
references.pmid: 8029738
references.citation: J Bone Joint Surg Br. 1960 Feb;42-B:40-59
references.pmid: 13854527
references.citation: J Child Neurol. 2010 Oct;25(10):1284-7
references.pmid: 20139402
references.citation: J Bone Joint Surg Br. 1988 Aug;70(4):534-8
references.pmid: 3403593
references.citation: Spine (Phila Pa 1976). 1995 Sep 1;20(17):1910-6
references.pmid: 8560340
references.citation: J Bone Joint Surg Br. 1982;64(4):393-8
references.pmid: 7047536
references.citation: Indian J Orthop. 2010 Oct;44(4):409-16
references.pmid: 20924482
references.citation: J Spinal Disord Tech. 2007 May;20(3):209-15
references.pmid: 17473640
references.citation: Am J Orthop (Belle Mead NJ). 1997 Nov;26(11):798-800
references.pmid: 9402217
references.citation: Indian J Orthop. 2012 Mar;46(2):150-8
references.pmid: 22448052
references.citation: Clin Orthop Relat Res. 2007 Jul;460:117-23
references.pmid: 17452923
references.citation: J Anat. 1975 Sep;120(Pt 1):49-68
references.pmid: 1184458