Abstract:

Objective To analyze the clinical effect of stageⅠanterior-posterior approach surgery for lumbar tuberculosis in children. Methods Clinical data of 68 lumbar tuberculosis children (male: 38, female: 30) who received stageⅠ anterior-posterior approach surgery in Beijing Children’s Hospital from February 2009 to February 2017 were retrospectively analyzed. They aged between 3 and 12 years with mean of (7.6±2.3) years, and the course of disease ranged from 3 to 10 months with mean of (5.6±1.5) months, with follow up of 36-48 months (mean, (41.2±3.4) months). Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Cobb angle, local kyphosis and function changes of spinal nerve cord before and after the operation, as well as fusion of bone graft the complications postoperative were observed. Results Three months after the operation, the ESR, CRP, Cobb angle and local kyphosis in patients were all significantly improved than those before the operation (20.2±5.8) mm/1 h vs. (50.2±13.3) mm/1 h, t=16.668, P<0.01; 8 (2, 10) mg/L vs. 20 (4, 30) mg/L, Z=-6.742, P<0.01; (11.6±3.7)° vs. (25.2±6.7)°, t=10.334. P<0.01; (35.6±5.4)° vs. (15.2±4.7)°, t=23.500, P<0.01). Change of spinal cord nerve function before the operation were found in 54 children (79.4%), however, the number was significantly decreased to 8 (11.8%) at the last visit (χ²=62.724, P<0.01). The bone graft fusion of all the 68 children reached the BridwellⅠ, and the fusion rate was 100% with duration of 3 to 11 months (mean, (6.6±2.1) months). Until the last follow-up, there were totally 4 cases (5.9%) suffering postoperative complications and getting better after receiving treatment. Conclusion Based on the usage of effective anti-tuberculosis medicines, stage Ⅰ anterior-posterior approach surgery could effectively improve the lumbar kyphosis deformity and nerve function of the tuberculosis children. The rate of bone graft fusion was high and occurrence of postoperative complications is rare, the clinical effect is significant.

Key words: Tuberculosis, spinal, Lumbar vertebrae, Child, Surgical procedures, operative, Treatment outcome, Evaluation studies