Abstract：
OBJECTIVE: This study aimed to investigate the clinical outcomes of posterior fixation, combined with one- or two-stage anterior debridement and bone grafting in treating children younger than 3 years of age with thoracic and lumbar tuberculosis.
METHODS: This was a retrospective study involving 16 young children with thoracic or lumbar tuberculosis. Surgical data were recorded. Frankel Grade was used to assess neurological function. The regional kyphosis angle was measured to evaluate the deformity correction. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were detected to assess the activity of tuberculosis. Bony fusion and complications were also recorded.
RESULTS: The mean operation time was 204.4 ± 41.8 min. The mean estimated blood loss was 126.3 ± 94.4 ml. Preoperative Frankel Grade results indicated five patients with Grade C, six with Grade D, and five with Grade E. At the final follow-up, all patients were in Grade E. Twelve patients were brought back to normal spinal alignment and the rest four patients remained kyphotic. There was an improvement of 29.3° ± 18.3° in regional kyphotic angle postoperatively. And the deformity correction was 27.4° ± 19.1° at the final follow-up. ESR and CRP decreased to a normal range at three months follow-up. Bony fusion was achieved in all patients. None of the cases developed fixation failure, pseudoarthrosis, or tuberculosis recurrence.
CONCLUSIONS: Posterior fixation, combined with one- or two-stage anterior debridement and bone grafting, is a safe and effective surgical strategy for treating young children with thoracic and lumbar tuberculosis.
METHODS: This was a retrospective study involving 16 young children with thoracic or lumbar tuberculosis. Surgical data were recorded. Frankel Grade was used to assess neurological function. The regional kyphosis angle was measured to evaluate the deformity correction. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were detected to assess the activity of tuberculosis. Bony fusion and complications were also recorded.
RESULTS: The mean operation time was 204.4 ± 41.8 min. The mean estimated blood loss was 126.3 ± 94.4 ml. Preoperative Frankel Grade results indicated five patients with Grade C, six with Grade D, and five with Grade E. At the final follow-up, all patients were in Grade E. Twelve patients were brought back to normal spinal alignment and the rest four patients remained kyphotic. There was an improvement of 29.3° ± 18.3° in regional kyphotic angle postoperatively. And the deformity correction was 27.4° ± 19.1° at the final follow-up. ESR and CRP decreased to a normal range at three months follow-up. Bony fusion was achieved in all patients. None of the cases developed fixation failure, pseudoarthrosis, or tuberculosis recurrence.
CONCLUSIONS: Posterior fixation, combined with one- or two-stage anterior debridement and bone grafting, is a safe and effective surgical strategy for treating young children with thoracic and lumbar tuberculosis.
摘要：
目的：本研究旨在探讨后路内固定的临床效果，联合一期或两期前路清创植骨治疗3岁以下儿童胸腰椎结核。
方法：这是一项回顾性研究，涉及16名胸椎或腰椎结核患儿。记录手术数据。FrankelGrade用于评估神经功能。测量局部后凸角度以评估畸形矫正。检测红细胞沉降率（ESR）和C反应蛋白（CRP）水平以评估结核病的活动性。还记录了骨融合和并发症。
结果：平均手术时间为204.4±41.8min。平均估计失血量为126.3±94.4ml。术前Frankel分级结果显示5例患者为C级,6级，D级，在最后的随访中，E级为5级，所有患者均为E级。12例患者恢复正常脊柱排列，其余4例患者保持后凸。术后局部后凸角改善29.3°±18.3°。最终随访时畸形矫正为27.4°±19.1°。随访3个月时ESR和CRP均降至正常范围。所有患者均实现骨性融合。没有一例发生固定失败,假关节炎,或结核病复发。
结论：后路固定，结合一期或两期前路清创术和植骨，是治疗幼儿胸腰椎结核的安全有效的手术策略。
方法：这是一项回顾性研究，涉及16名胸椎或腰椎结核患儿。记录手术数据。FrankelGrade用于评估神经功能。测量局部后凸角度以评估畸形矫正。检测红细胞沉降率（ESR）和C反应蛋白（CRP）水平以评估结核病的活动性。还记录了骨融合和并发症。
结果：平均手术时间为204.4±41.8min。平均估计失血量为126.3±94.4ml。术前Frankel分级结果显示5例患者为C级,6级，D级，在最后的随访中，E级为5级，所有患者均为E级。12例患者恢复正常脊柱排列，其余4例患者保持后凸。术后局部后凸角改善29.3°±18.3°。最终随访时畸形矫正为27.4°±19.1°。随访3个月时ESR和CRP均降至正常范围。所有患者均实现骨性融合。没有一例发生固定失败,假关节炎,或结核病复发。
结论：后路固定，结合一期或两期前路清创术和植骨，是治疗幼儿胸腰椎结核的安全有效的手术策略。
