关键词: 结核,脊柱/外科学, 胸廓切开术, 胸椎, 脊柱后凸, 骨钉, 内固定器, 儿童

Abstract: Objective  To evaluate efficacy of posterior transpedicular fixation combined with anterior thoracotomy debridement to treat thoracic spinal tuberculosis in children.  Methods  Thirty-five cases admitted in our hospital from Jan. 2004 to Dec. 2010 were taken posterior transpedicular fixation combined with anterior thoracotomy debridement. Among the 35 cases, there were 13 cases with varying degrees of paralysis and one case with urinary retention. All cases were postoperatively followed up for 1 to 7 years, average 3.5 years, and to be analyzed the local lesions recurrence or not, symptom improvement and correction of kyphosis in the short-term and long-term variation. Results  Thirty-five patients were all cured and found no recurrence. Of the 13 patients with varying degrees of paralysis, lower extremity muscle strength was increased by 1 to 3 levels. The patient with urinary retention postoperatively recovered at 5th month later. Of all cases, the preoperative average kyphosis cobb’s angle was 42°(20°to 55°), and postoperative average cobb’s angle was 22°(5°to 38°) in the short-term and still 22°(5° to 40°) in the long-term. Among the 35 cases, 17 cases were removed the implants after 2 to 3 years. Conclusion  Posterior transpedicular fixation combined with anterior thoracotomy debridement taken to treat thoracic spinal tuberculosis in children can complete debridement, decompress spinal cord thoroughly, provide rib bone to be grafted, reconstruct spinal stability, correct kyphosis deformity effectively and prevent kyphosis increased.

Key words: Tuberculosis, spinal/surgery, Thoracotomy, Thoracic vertebrae, Kyphosis, Bone nails, Internal fixatiors, Child