Abstract
ObjectiveThis study aims to explore the efficacy and safety of posterior vertebral column resection (PVCR) in treating thoracolumbar spinal tuberculous angular kyphosis (TSTAK).MethodsFrom January 2008 to January 2012, 17 TSTAK patients were treated surgically, including five males and 12 females, with an average age of 23.6 years, among five cases who had the kyphotic apical vertebrae located at the thoracic vertebrae, ten cases were located at the thoracolumbar segment, and two cases were located at the lumbar vertebrae. The kyphotic Cobb angle was measured in the preoperative, postoperative, and final follow-up, respectively, and the nerve function ASIA classification was assessed.ResultsThe mean operative time was 364 min; the average intraoperative blood loss was 2,218 ml; and the average intraoperative blood transfusion was 1,863 ml. Among the five patients with the preoperative nerve function as grade D, four of them recovered to grade E. The preoperative average Cobb angle was 81.3° ± 12.8°, while the postoperative average Cobb average was 17.3° ± 3.6°; while it was significantly improved than the preoperative (P < 0.01), the average kyphosis correction rate was 68.7% ± 6.5%; the postoperative average follow-up was 18.7 months, with an average correction loss as 3.3°.ConclusionPVCR could be safely and effectively used in TSTAK.
Highlights
According to the reports of WHO, no matter in the developed or developing countries, the occurrence of tuberculosis (TB) was showing a rising trend, and in 2011, more than 9 million new TB patients were reported around the world, as well as 1.4 million cases of death [1]
The correction surgery of thoracolumbar kyphosis should be based on the different kyphotic angles and the patients’ specific circumstances, using the anterior, posterior, or combined approach for the orthopedic surgeries
Such a variety of diseases as the spinal tuberculosis, congenital spinal deformity, and spinal trauma could lead to the increase of spinal kyphotic angle, which were the common causes of kyphosis
Summary
According to the reports of WHO, no matter in the developed or developing countries, the occurrence of tuberculosis (TB) was showing a rising trend, and in 2011, more than 9 million new TB patients were reported around the world, as well as 1.4 million cases of death [1]. The rapid growth of global population was one of the reasons for the continuous rise of TB cases. Most spinal tuberculosis patients could obtain the cure through a standardized. The correction surgery of thoracolumbar kyphosis should be based on the different kyphotic angles and the patients’ specific circumstances, using the anterior, posterior, or combined approach for the orthopedic surgeries. The anterior approach existed such defects as low kyphosis-orthopedic rate, often with residual kyphosis, postoperative fibrosis, and adhesions; and when the kyphosis was above 60° and the pleural adhesions existed, it would be difficult to expose the lesions [9,10]
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