Current possibilities of surgical treatment for infectious spondylitis in children

Naumov D.G., Mushkin A.I., Pershin A.A.

Abstract


Aim
To analyze the immediate and long-term results of the surgical treatment of infectious spondylitis in children.
Materials and methods
A retrospective cohort design was implemented with the following inclusion criteria: 1) age below 18 years, 2) titanium mesh block cage for anterior spondylodesis, and 3) follow up period of 24 months. The mean age was 15.3 ± 2.8 years. The patients were divided into two groups according to diagnosis: active tuberculous spondylitis (n1 = 42) and chronic non-specific spondylitis and its consequences (n2 = 41).
Results
There were no complications or process aggravation within a period of 6 months after surgery. However, there was one case of mesh cage destabilization when tuberculous spondylitis progressed in the period from 6 to 12 months. The amount of kyphosis correction was 26.5° ± 10.1°. The postoperative deformity increase at 18 months after surgery did not exceed 5°. Bone block was estimated at 3 points in 95 % of cases 6 months after surgery and at 4 or 5 points in 97 % of cases 12 months after surgery. Neurological disorders, based on Frankel evaluation before surgery, were identified in 5 patients (Type D in 3 patients, Type B in 2 ), and complete regression was observed after surgery in 4 cases up to Type Е and 1 case up to Type D. Operative blood loss was M ± m = 207.9 ± 139.1.
Conclusion
The use of titanium mesh block cages in children with infectious spondylitis is a safe procedure that reduces the number of complications in the immediate and long-term postoperative period as well as maintains the stability of surgical correction of the spine deformity.

Keywords


spondylitis, tuberculosis, spondylodesis, titanium mesh block cages, children

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