Abstract:

BACKGROUND: The anterior fixation can reconstruct the stability and support functions of the spinal column, and meanwhile, promote fusion through providing compressive stress between the bone grafts bed and bone graft.
OBJECTIVE: To study the application of anterior debridement and fusion with freeze-dried bone allografts in treating pediatric spinal tuberculosis.
METHODS: Twenty-seven children with spinal tuberculosis were collected and analyzed retrospectively. All the patients were treated by anterior debridement, allogeneic bone grafting and internal fixation. Then, anti-tuberculosis treatment lasted for 12-18 months in all the 27 cases.
RESULTS AND CONCLUSION: All of the patients were followed up for 6 months to 2.5 years. According to Bridwell criteria, there were 14 cases of Ⅰ grade, 11 cases of Ⅱ grade, two cases of Ⅲ grade. Five of the 27 cases were accompanied by incomplete paralysis of the lower limbs and recovered after internal fixation, including three cases of grade D and two cases of grade E according to Frankel grading. Debridement surgery and internal fixation with allogeneic bone grafting were respectively implemented at 3 months and 6 months after operation in one case of C6-7 tuberculous because of sinus formation, fixation loosening and shedding and allogeneic bone collapse. Another case of thoracic spine tuberculosis at T9-11 segments presented with mild kyphotic deformity that the Cobb’s angle was 20°, as well as bone growth retardation occurred after the anterior fixation was removed and posterior interbody fusion was performed. These findings indicate that it is safe and feasible to carry out anterior debridement and fusion with freeze-dried bone allografts in children with spinal tuberculosis on the basis of systemic anti-tuberculosis.