The Journal of Bone and Joint Surgery, Vol 76, Issue 5 701-708, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
The effect of age on the change in deformity after radical resection and anterior arthrodesis for tuberculosis of the spine
SS Upadhyay, MJ Saji, P Sell and AC Yau
Duchess of Kent Children's Hospital, Hong Kong.
We compared the long-term changes in spinal deformity after a radical
operation for tuberculosis of the spine in thirty-three children who were
ten years old or younger at the time of the operation with those of
seventy-one adult patients who were at least eighteen years old at the time
of the operation. The spinal deformity was measured with use of the angles
of kyphosis and deformity as assessed on lateral spinal radiographs made
preoperatively and postoperatively at six months, one year, and five years
and at the most recent follow-up evaluation (at a mean of fifteen years).
We detected no significant difference in the mean angles of kyphosis and
deformity between the children and the adults postoperatively at any
follow-up evaluation; thus, we found that growth of the posterior portion
of the spine does not contribute to the progression of deformity after a
radical anterior procedure. The children who had tuberculosis of the
thoracic spine had much better correction than the adults at the six-month
follow-up examination. This correction was maintained. However, there were
no such differences in the correction of the deformity between the adults
and the children who had tuberculosis of the thoracolumbar or the lumbar
spine. Our findings clearly show that a short anterior spinal arthrodesis
done at an early age was not associated with progression of deformity
during growth and development in our patients. The longitudinal pattern of
changes in deformity was similar in the children and the adults, and there
was no evidence of disproportionate posterior spinal growth contributing to
the progression of deformity after anterior spinal arthrodesis.(ABSTRACT
TRUNCATED AT 250 WORDS)
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