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Background: There is limited evidence to guide treatment for pediatric cervical spinal tuberculosis with kyphosis (PCSTK). This study retrospectively evaluates the safety, feasibility and efficacy of 360-degree arthrodesis combined with anterior debridement and decompression for treating PCSTK, while simultaneously emphasizing the role of posterior fixation for the correction and maintenance of the kyphosis angle. Methods: From May 2006 to December 2012, a total of 12 children with PCSTK underwent 360-degree cervical spinal arthrodesis followed by debridement of focus and decompression of the spinal cord. Data on the angle of kyphosis correction, visual analogue scale scores of pain, the American Spinal Injury Association scoring system of nerve function scores, erythrocyte sedimentation rate (ESR) and body weight were collected at certain periods. Clinical efficacy was evaluated by statistical analysis based on collected data. Results: Average follow-up period was 34.3 ± 8.6 months. No postoperative complications related to the instrumentation occurred, and neurologic function improved in various degrees. Preoperative kyphosis angle was 41.4 ± 5.2°, and significantly decreased to -4.9 ± 4.9° after surgery. The correction of kyphosis and loss of correction were 47.1 ± 4.9° and 0.6 ± 1.4°, respectively. Average pretreatment ESR was 49.8 ± 13.2 mm/h, which normalized (8.5 ± 0.6 mm/h) within three months in all patients. Average preoperative visual analogue scale was 6.6 ± 1.6, which decreased to 2.3 ± 1.4 postoperatively and 0.3 ± 0.5 during the final follow-up. Mean preoperative body weight was 25.9 ± 5.1 kg, and body weight was 33.5 ± 4.8 kg at the third month of post-operation. Bone healing was achieved in all patients after a mean period of 5.4 months. Conclusions: 360-degree arthrodesis combined with anterior debridement and decompression is a safe and effective method for the treatment of PCSTK. For the correction and maintenance of the kyphosis angle, additional posterior fixation is recommended. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence to guide treatment for pediatric cervical spinal tuberculosis with kyphosis (PCSTK). This study retrospectively evaluates the safety, feasibility and efficacy of 360-degree arthrodesis combined with anterior debridement and decompression for treating PCSTK, while simultaneously emphasizing the role of posterior fixation for the correction and maintenance of the kyphosis angle., Methods: From May 2006 to December 2012, a total of 12 children with PCSTK underwent 360-degree cervical spinal arthrodesis followed by debridement of focus and decompression of the spinal cord. Data on the angle of kyphosis correction, visual analogue scale scores of pain, the American Spinal Injury Association scoring system of nerve function scores, erythrocyte sedimentation rate (ESR) and body weight were collected at certain periods. Clinical efficacy was evaluated by statistical analysis based on collected data., Results: Average follow-up period was 34.3 ± 8.6 months. No postoperative complications related to the instrumentation occurred, and neurologic function improved in various degrees. Preoperative kyphosis angle was 41.4 ± 5.2°, and significantly decreased to -4.9 ± 4.9° after surgery. The correction of kyphosis and loss of correction were 47.1 ± 4.9° and 0.6 ± 1.4°, respectively. Average pretreatment ESR was 49.8 ± 13.2 mm/h, which normalized (8.5 ± 0.6 mm/h) within three months in all patients. Average preoperative visual analogue scale was 6.6 ± 1.6, which decreased to 2.3 ± 1.4 postoperatively and 0.3 ± 0.5 during the final follow-up. Mean preoperative body weight was 25.9 ± 5.1 kg, and body weight was 33.5 ± 4.8 kg at the third month of post-operation. Bone healing was achieved in all patients after a mean period of 5.4 months., Conclusions: 360-degree arthrodesis combined with anterior debridement and decompression is a safe and effective method for the treatment of PCSTK. For the correction and maintenance of the kyphosis angle, additional posterior fixation is recommended.

Background: There are quite a few controversies on the surgical management of single-segment thoracic spinal tuberculosis with neurological deficits (STSTND). In this study, the clinical efficacy and feasibility of one-stage posterior-only transpedicular debridement, interbody fusion, and posterior instrumentation for treating STSTND in adults were retrospectively evaluated., Methods: Thirty-four cases with STSTND underwent one-stage posterior-only transpedicular debridement, interbody fusion and posterior instrumentation at the same institution from January 2003 to January 2013. Follow-up time was 34.4 ± 10.2 months (range, 18-48 months), and kyphosis angle was 34.1 ± 12.3°. The American Spinal Injury Association (ASIA) classification of spinal cord injury was employed to evaluate neurological deficits, while visual analogue scale (VAS) was employed to assess the degree of pain. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were used to evaluate the activity of tuberculosis (TB)., Results: All 34 patients with spinal tuberculosis (ST) were completely cured, and there was no recurrence of TB. Postoperative kyphosis angle was 8.2 ± 1.8°, and there was no significant loss of correction during the final follow-up. Solid fusion was achieved and pain was relieved in all cases. Neurological condition in all patients improved after surgery., Conclusions: One-stage posterior-only transpedicular debridement, interbody fusion, and posterior fixation followed by chemotherapy seems to be adequate for obtaining satisfactory healing of single-segment thoracic spinal tuberculosis with neurological deficits. Careful patient selection is critical to the successful outcome with this technique.

Study Design: This is a retrospective case-control study., Objectives: The surgical approaches to cervicothoracic spinal tuberculosis (CTSTB) were controversial. The aim of this research is to retrospectively compare the efficacy and feasibility of anterior-only (AO) approach, combined anterior and posterior (AP) surgeries, and posterior-only (PO) approach for the treatment of CTSTB., Methods: AO approach was undertaken in 20 patients (group A), AP fusion was carried out in 18 patients (group B), and PO surgery was performed in 21 patients (group C). Surgery duration, intraoperative blood loss, length of hospitalization, neurological status, kyphosis angle correction, loss of correction, and complications of the three groups were compared., Results: Three surgical approaches all improved the kyphosis deformity and neurological function significantly (P < 0.05). The mean loss of correction in group A in the final follow-up was higher than in groups B and C (P < 0.05), and the difference between groups B and C was not significant (P > 0.05). The mean operation time, blood loss, and hospitalization days in group B were greater than in groups A and C. Complications were most prevalent in group A, more in group B, and the least in group C., Conclusion: The AO approach surgery should be limitedly used for severe CTSTB. The AP approach had got satisfactory clinical and radiographic outcomes, but with larger trauma and more complications, which should be reservedly performed for mild CTSTB. Compared to traditional surgery, PO surgery can significantly improve clinical results and obviously relieve postoperative complications.