SPINAL TUBERCULOSIS IN PEDIATRIC POPULATION

Abstract

Background: There is a lack of reports on spinal tuberculosis in children. We report a retrospective analysis of 124 children with TB spine treated over 30 years. Materials and Methods: One hundred twenty-four patients were included in our study. Ninety-one children were treated conservatively, while 33 children were subjected to surgery for focal debridement (n=23), posterior interspinous wiring and cementation (n=4), and posterior instrumentation with rods and segmental wiring (n=14). Thus, some of the children in the current series belonged to conservative study patients. Results: All children attained healed status and showed neural recovery (n=18). The patients attained healed status at 12 months. Spontaneous intracorporal fusion occurred only in 8.06% of 124 children. Sagittal curves during growth showed three different patterns: Unchanged, decreased, and increased curves. The residual kyphosis was unavoidable in cases with growth plate damage. Kyphosis increased in cases with wedged monovertebra and fused wedged block vertebra, though it was different at a different level. Conclusion: The posterior instrumented stabilization alone could correct or prevent the progress of the kyphosis. However, for active tuberculosis, posterior instrumented stabilization combined with anterior radical surgery should be reserved only for advanced tuberculosis with instability, the rapid progress of kyphosis, and unacceptable pre-existing kyphosis. There is a new trend of prophylactic posterior instrumentation, even for early tuberculosis.