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| MAO Ningfang,ZHAO Yingchuan,CHEN Zhiqiang.One-stage anterior approach for lower cervical spinal tuberculosis complicated with kyphosis，a study of over 5 year follow-up[J].Chinese Journal of Spine and Spinal Cord,2011,(10):813-818. |
| One-stage anterior approach for lower cervical spinal tuberculosis complicated with kyphosis，a study of over 5 year follow-up |
| Received:May 12, 2011 Revised:July 26, 2011 |
| English Keywords:Tuberculosis Lower cervical spine Kyphosis deformity Operation Therapeutic effect |
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| English Abstract: |
| 【Abstract】 Objective：To observe the minimun five-year follow-up of one-stage anterior debridement，autograft and instrumentation for lower cervical spinal tuberculosis（TB） complicated with kyphosis.Method：15 cases suffering from lower cervical spinal TB complicated with kyphosis（9 males and 6 females with the average age at operation of 39 ranging from 25 to 58） underwent one-stage anterior debridement，autograft and instrumentation from October 2003 to April 2006.A total of 32 vertebrae were involved（2 vertebrae in 13 cases and 3 vertebrae in 2 cases）.The defect sites were C3-C4 in 4 cases，C4-C5 in 3 cases，C5-C6 in 5 cases，C6-C7 in 1 case，C3-C5 in 1 case and C4-C6 in 1 case.The average neck pain VAS score was 8（range，6-10） before surgery，and the preoperative Frankel grade included 2 grade B，4 grade C，7 grade D，2 grade E.The average preoperative Cobb angle was 28.0°（range，15°-50°）.Anti-TB chemotherapy treatment was performed for 10 to 15 months perioperatively（12 months on average）.Result：Laryngeal edema was found in one patient one day after surgery，and healed after corresponding intervention.All 15 cases were followed up for an average of 72 months（range，61-88 months）.Neck pain VAS scores were 1-5（average，3.5） at 1 week after operation，which were significantly lower than preoperative ones（P＜0.01）；0-1（average，0.4） at 1 year after operation，which were significantly lower than the 1 week ones（P＜0.05）；and 0-4（average，2） at final follow-up.Neck pain VAS scores at 1 year were significantly lower than the final follow-up ones（P＜0.05）.Of 13 cases with neurological deficit，9 patients had Frankel grade improved 1 level，and 4 patients had it improved 2 levels.The average Cobb angle of cervical spine was -2.4°（range，-8°-2°） one week after operation，which was significantly lower than preoperative one（P<0.01）；and -2.1°（range，-7°-2°） at final follow-up，which remained no change with 1 week one（P>0.05）.Solid bone fusion was achieved in all patients with the average fusion time of 4.5 months（range，3-8 months）.3 patients complained of pain in bone donor site，and no pain relief was noted in 1 till final follow-up.Adjacent segment degeneration was found in 6 patients and less than 2mm of autograft subsidence was found in three cases.No instrument failure and no recurrence of tuberculosis were noted at final follow-up.Conclusion：The results of minimum 5-year follow-up show reliable outcome of one-stage anterior debridement，autograft and instrumentation for lower cervical spinal tuberculosis complicated with kyphosis on the basis of standard anti-TB chemotherapy medicine. |
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