title: One-stage posterior focus debridement, interbody grafts, and posterior instrumentation and fusion in the surgical treatment of thoracolumbar spinal tuberculosis with kyphosis in children: a preliminary report.
abstract: OBJECTIVE
  The purpose of this study was to determine the efficacy and feasibility of surgical management of children with thoracolumbar spine tuberculosis with kyphosis by using one-stage posterior focus debridement, interbody grafts, and posterior instrumentation and fusion.
  
  
  METHODS
  From October 2010 to September 2013, 21 children with thoracolumbar spinal tuberculosis accompanied by kyphosis were treated with one-stage posterior decompression, interbody grafts, and posterior instrumentation and fusion. There were 13 males and 8 females, aged from 7 to 13 years old (average age 9.9 years). The mean follow-up was 34 months (range26-48 months). Patients were evaluated before and after surgery in terms of ESR, neurologic status, pain, and kyphotic angle.
  
  
  RESULTS
  Spinal tuberculosis was completely cured, and the grafted bones were fused in all 21 patients. There was no recurrent tuberculous infection. ESR got normal within 3 months in all patients. The ASIA neurologic classification improved in all cases. Pain relief was obtained in all patients. The average preoperative kyphosis was 29.7° (range 12-42°) and decreased to 5.5° (range 2-10°), postoperatively. There was no significant loss of the correction at the latest follow-up.
  
  
  CONCLUSIONS
  Our results show that one-stage posterior decompression, interbody grafts, and posterior instrumentation and fusion were an effective treatment for children with thoracolumbar spinal tuberculosis. It is characterized as minimum surgical trauma, good neurologic recovery, good correction of kyphosis, and prevention of progressive kyphosis.
authors.affiliation: From the Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Yu-Xiang
authors.initials: YX
authors.lastname: Wang
authors.affiliation: From the Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China. zhanghongqi9996@sina.com.
authors.forename: Hong-Qi
authors.initials: HQ
authors.lastname: Zhang
authors.affiliation: From the Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Ming-Xing
authors.initials: MX
authors.lastname: Tang
authors.affiliation: From the Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Chao-Feng
authors.initials: CF
authors.lastname: Guo
authors.affiliation: From the Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Ang
authors.initials: A
authors.lastname: Deng
authors.affiliation: From the Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Jian-Huang
authors.initials: JH
authors.lastname: Wu
authors.affiliation: From the Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Jin-Yang
authors.initials: JY
authors.lastname: Liu
authors.affiliation: From the Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Zhansheng
authors.initials: Z
authors.lastname: Deng
authors.affiliation: From the Department of Spine Surgery, Xiangya Spinal Surgery Center, Xiangya Hospital of Central South University, ChangSha, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D001799:Blood Sedimentation; D002648:Child; D003646:Debridement / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007738:Kyphosis / Q000209:etiology* / Q000601:surgery*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000379:methods*; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal / Q000150:complications*
keywords: Children; Kyphosis; Posterior approach; Spine tuberculosi; Thoracolumbar