Halo traction, single-segment circumferential fixation treating cervical tubercular spondylitis with kyphosis.
OBJECTIVE
To evaluate the clinical efficacy and feasibility of twenty patients with cervical tubercular spondylitis with kyphosis (CTSK) treated by halo traction, single-segment circumferential instrumented fusion combined anterior debridement, decompression and bone grafting.


METHODS
Retrospective review of data on twenty patients who suffered from CTSK admitted to our hospital between January 2007 and December 2012. All of them were performed by halo traction, single-segment circumferential instrumented fusion (anterior titanium plate and posterior pedicle or lateral mass fixation) combined anterior debridement, decompression and titanium mesh cage (TMC) filled with allograft bone particles. X-ray and computed tomographic (CT) images were used to determined sagittal balance and bone fusion. The clinical efficacy was evaluated using statistical analysis about the visual analogue scale (VAS) scores of pain, neurological status according to the Frankel classification and erythrocyte sedimentation rate (ESR), which were collected at certain time.


RESULTS
The average follow-up period was 34.1 ± 7.0 months (24-48 months). In the 20 cases, no obvious postoperative complications related to instrumentation and bone grafting and neurologic function was improved in various degrees. The average pretreatment ESR was 46.4 ± 21.7 mm/h, which got normal within 3 months in all patients. The average VAS on admission was 6.7 ± 1.7, which decreased to 1.6 ± 1.1 postoperatively. All patients got bony fusion within 3.4-5.5 months after surgery. The Cobb angle of 30.8 ± 10.5° on admission reduced to 2.9 ± 3.9° performed by preoperative halo traction, became to -5.1 ± 4.0° after operation and remained at -4.3 ± 3.8°, with 0.9 ± 0.7° of correction loss.


CONCLUSIONS
Halo traction, single-segment circumferential instrumented fusion combined anterior debridement, decompression and TMC can be an effective and safe treatment method for the treatment of cervical tubercular spondylitis with kyphosis and the preoperative halo traction should be laid on much emphasis.
Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China.
Hao
H
Zeng
Department of Psychiatry, Brains Hospital of Hunan Province, 427#, the Three Section of Furong Road, Changsha, Hunan 410007, People's Republic of China.
Yingfang
Y
Liang
Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China. Electronic address: 2621132371@qq.com.
Xiyang
X
Wang
Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China.
Xiongjie
X
Shen
Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China.
Chengke
C
Luo
Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China.
Zhengquan
Z
Xu
Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China.
Zheng
Z
Liu
Department of Spine Surgery, the Xiangya Hospital of Central South University, 87# Xiangya Road, Changsha, Hunan 410008, People's Republic of China.
Yupeng
Y
Zhang
D016025:Bone Transplantation / Q000379:methods; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D003646:Debridement / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D019736:Prostheses and Implants; D011859:Radiography; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013166:Spondylitis / Q000000981:diagnostic imaging / Q000601:surgery*; D014025:Titanium; D014143:Traction / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000000981:diagnostic imaging / Q000601:surgery*
D014025:Titanium
Anterior and posterior approaches; Circumferential fusion; Kyphosis; Single-segment; Tubercular spondylitis