One-stage posterior debridment, bone grafting and internal fixation for cervicothoracic tuberculosis accompanied by kyphosis in children

Objective To investigate the effectiveness and feasibility of surgical management for cervicothoracic tuberculosis accompanied by kyphosis in children by using debridment, bone grafting and internal fixation through one-stage posterior approach. Methods From May 2005 to March 2008, 8 children with cervicothoracic tuberculosis accompanied by kyphosis were admitted to our hospital, of which 5 cases were male and 3 cases were female. Their age ranged from 3 to 10 years. Clinical features included thoracic and back pain, low-grade fever, night sweat and kyphosis. The kyphotic angle ranged from 30 to 75 degrees before operation, 52.1 degrees in average. ASIA score system was used to evaluate the neurological deficits. The results showed that there were 1 case in B grade, 5 cases in C grade and 2 cases in D grade. All cases were treated with debridement, decompression, bone grafting and internal fixation by one-stage posterior approach. Results The patients were followed up for 12 to 36 months, 30 months in average. All incisions were healed perfect without recurrence. ASIA score system indicated that 3 cases were improved by 2 grades, and 5 cases by 1 grade. The postoperative kyphotic angle was 10 to 26 degrees and there was no significant loss of the correction at the latest follow-up. The ESR was decreased to normal level 3 months postoperatively. Solid fusion was achieved within 4 to 8 months, 6 months in average. Conclusion It is an effective method to use one-stage debridment, bone grafting and internal fixation from posterior approach to treat pediatric cervicothoracic tuberculosis accompanied by kyphosis. It can not only correct the kyphosis but also prevent the late kyphosis progress.