Surgical management of complex post-tuberculous kyphosis among African patients: clinical and radiographic outcomes for a consecutive series treated at a single institution in West Africa.

医学 外科 后凸 柯布角 回顾性队列研究 射线照相术 脊柱融合术 骨科手术 脊柱侧凸 Oswestry残疾指数 肺结核 畸形
作者
Ali M. Maziad,Owoicho Adogwa,Henry Ofori Duah,Kwadwo Poku Yankey,Derrick Nyantakyi Owusu,Arthur Sackeyfio,Mabel Adobea Owiredu,Tyler Wilps,Gerhard Ofori-Amankwah,Franklin Coleman,Harry Akoto,Irene Wulff,Oheneba Boachie-Adjei
出处
期刊:Spine deformity [Springer Science+Business Media]
卷期号:9 (3): 777-788
标识
DOI:10.1007/s43390-020-00258-3
摘要

Retrospective review of consecutive series. To assess the clinical and radiographic outcomes after surgical management of post-tuberculous kyphosis. Post-tuberculous (TB) kyphosis can lead to progressive pulmonary and neurological deterioration. Surgery is indicated to decompress neural elements and correct the spine deformity. Although posterior vertebral column resection (PVCR) has been established as the treatment of choice for severe TB kyphosis, there is paucity of studies on the clinical outcomes among patients treated in West Africa. Clinical and radiographic data of 57 patients (pts) who underwent surgical correction of post-TB kyphosis at a single site in West Africa between 2013 and 2018 (≥ 2-year follow-up in 36 pts, ≥ 1-year FU in 21 pts). Pre- and post-op SRS scores and radiographic outcomes were compared using Paired t test. 57 patients, 36M:21F. Mean age 19 (11–57 years). 22/57 pts (39.3%) underwent pre-op halo gravity traction (HGT) for an average duration of 86 days (8–144 days). HGT pts had a higher baseline regional kyphosis (125.1 ± 20.9) compared to non-HGT pts (64.6 ± 31.8, p   0.05. Complication rates were similar among HGT and non-HGT groups. Significant improvements from baseline were seen in the average SRS Total and domains scores and radiographic measurements for patients who attained 2-year follow-up. PVCR ± HGT can provide safe and optimal correction in cases of severe post-TB kyphosis with good clinical and radiographic outcomes in underserved regions.

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