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International Orthopaedics
Published in: International Orthopaedics 2/2012

01-02-2012 | Original Paper

The surgical treatment and related management for post-tubercular kyphotic deformity of the cervical spine or the cervico-thoracic spine

Authors: Yang Liu, Yuanyuan Chen, Lili Yang, Xuhui Zhou, Ce Wang, Min Qi, Wen Yuan

Published in: International Orthopaedics | Issue 2/2012

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Abstract

Purpose

The outcomes of surgical treatment and related complications of post-tubercular kyphotic (PTK) deformity of the cervical spine or the cervico-thoracic spine were evaluated.

Methods

From January 2005 to October 2010, 12 cases with PTK (7 males, 5 females) with an average age of 30 years (range 21–43 years) formed the study group. There were ten patients with cervical deformities and two with cervico-thoracic kyphosis. Neurological function of all the patients was evaluated by the Japanese Orthopaedic Association (JOA) score and visual analogue scale (VAS) score. Two patients with severe cervico-thoracic deformity received modified skeleton traction pre-operatively. Ten patients underwent anterior debridement and reconstruction, using iliac crest or cages with autografts, while two patients with cervico-thoracic kyphosis received posterior instrumentation and fusion.

Results

The mean pre-operative focal kyphotic angle was 42.58° (range 30–67°), reducing to −8° (range −15–11°) postoperatively (at the last follow-up visit). The average operating time was 117.50 min (80–200 min) with an average blood loss of 110 ml (range 50–300 ml). Neurological assessment of all the patients, using the Japanese Orthopaedic Association (JOA) score and visual analogue scale (VAS) score, was improved significantly after surgery. All patients had solid fusion and no major complication was observed in the follow-up.

Conclusion

One-stage anterior debridement, instrumentation and fusion for cervical spinal TB and single posterior instrumentation for cervico-thoracic spinal TB followed by chemotherapy is practical to correct PTK. The procedure has the advantage of lower blood loss, effective kyphosis correction and minimal complications. To patients with severe deformity, skeletal traction seemed indispensible.
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Metadata
Title
The surgical treatment and related management for post-tubercular kyphotic deformity of the cervical spine or the cervico-thoracic spine
Authors
Yang Liu
Yuanyuan Chen
Lili Yang
Xuhui Zhou
Ce Wang
Min Qi
Wen Yuan
Publication date
01-02-2012
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 2/2012
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-011-1438-9

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