title: [Clinical results of the patients with severe kyphosis and paraplegia in different spine segment due to tuberculosis of thoracic and lumbar treated by one stage posterior surgical procedure to debriment of lesion bone fusion with internal fixation by pedicle screw system].
abstract: Objective:To evaluate the clinical results of the patients with severe kyphosis and paraplegia in different spine segment due to tuberculosis of thoracic and lumbar had been treated by one stage posterior surgical procedure to debriment of lesion and titian mesh bone fusion with internal fixation by pedicle screw system.Method:From May 2008 to March 2014, there were total 30 patients with severe kyphosis and paraplegia in different spine segment due to tuberculosis of thoracic and lumbar in Department of Orthopaedics, the People's Hospital of Xinjiang Uygur Autonoumy Region.The average age was 27 years, ranging from 11-65 years old, 21 male and 9 female.Tuberculosis lesion were located in differental spine segment: T3-54 four cases, T6-10ten cases, T11-L2twelve cases, L3-L5four cases, two vertebral bodies were involved in 6 cases, three vertebralbodies were involved in 12 cases, and four vertebral bodies were involved in 10 cases.All patients were treated by one stage posterior surgical procedure to debriment of lesion and titian mesh bone fusion with internal fixation of pedicle screw system .There were investigated the period of bone grafting fusion, kyphosis deformity correction degree , ESR, CRP preoperatively and postoperatively were compared before and after operation, and neurological function recovery record postoperatively, and neurological function recovery record postoperatively.Result:In the final follew-up, all patients got solid fusion in a average of eight months.The kyphosis deformity was corrected from(77±12)°preoperatively to(9.7±1.6)°postoperatively, in a average of 57°, the result is significant(P<0.05). The value of ESR degraded from(64±44)mm/h preoperatively to(15±7)mm/h, through statistic analyzing, the change of ESR value between postoperative and preoperative is significant(P<0.05) .The value of CRP degraded from(72±40)mg/L preoperatively to(13±5)mg/L postoperatively, via statistic analyzing, the change of CRP value between postoperative and preoperative is significant(P<0.05). All Patients neurological function deficiency achieved complete recovery, the longest time being within 8 months.All patients were cured thoroughly and there was no seroius complication.Conclusion:The one stage debriment of lesion and threaded fusion cage with internal fixation of vertebral pedicle surgical procedure, according to the extent of severe kyphosis and paraplegir due to tuberculosis of thoracic and lumbar vertebrae can achieve thoroughly debridement of tuberculosis, solid interbody fusion, good correction of deformity and forever stability of spine with posterior internal fixation, it get successfully rehablitation for neurological function and improve the life quality.
authors.affiliation: Department of Orthopaedics, the People's Hospital of Xinjiang Uygur Autonoumy Region, Urumqi 830001, China.
authors.forename: J
authors.initials: J
authors.lastname: Tayierjiang
authors.affiliation: Department of Orthopaedics, the People's Hospital of Xinjiang Uygur Autonoumy Region, Urumqi 830001, China.
authors.forename: N
authors.initials: N
authors.lastname: Waresijiang
authors.affiliation: Department of Orthopaedics, the People's Hospital of Xinjiang Uygur Autonoumy Region, Urumqi 830001, China.
authors.forename: H
authors.initials: H
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis; D002357:Cartilage Diseases; D002648:Child; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D007738:Kyphosis; D008159:Lumbar Vertebrae; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D010264:Paraplegia; D065289:Pedicle Screws; D011184:Postoperative Period; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D020127:Recovery of Function; D013904:Thoracic Vertebrae; D016896:Treatment Outcome; D014399:Tuberculosis, Spinal; D055815:Young Adult