Spinal Osteotomy For Thoracolumbar Tuberculosis Complicated With Kyphosis Does Not Further Shorten Existing Shortened Spinal Cord

Objective: This study aims to observe the efficacy of single posterior vertebral osteotomy and the debridement treatment of the active stage of thoracolumbar tuberculosis complicated with kyphosis deformity, and to determine whether the current shortened spinal cord would be further shortened after osteotomy. Methods: A retrospective analysis was conducted on 32 patients who were treated from 2009 to 2012. Patients were treated with single posterior vertebral osteotomy, debridement and internal fixation. VAS and ODI were used to evaluate lower back pain and nerve function. The TraumaCad (TM) system was used to detect local kyphotic angle and spinal height changes. Results: VAS and ODI scores were improved from preoperative 5.81 +/- 1.15 and 47.47 +/- 9.813 to postoperative 1.75 +/- 0.67 and 89.80 +/- 3.59%, respectively (P<0.01). Preoperative local kyphotic angle was 38.38 degrees +/- 13.60 degrees, and was 7.47 degrees +/- 2.9 degrees upon followed-up (P<0.01). Furthermore, the rate of shrinkage of the height of the spinal cord increased from preoperative 49.48 +/- 17.67% to 88.32 +/- 20.74%, with an increase of 37.32 +/- 12.77%. Correlations of the newly increased postoperative shrinkage rate between the preoperative shrinkage rate and local kyphotic angle were not remarkable, and R values were 0.535 and 0.512, respectively. Conclusion: Under the control of normative anti-tuberculosis drugs, single posterior debridement and spinal shortened osteotomic internal fixation can effectively treat patients with active thoracic and lumbar spinal tuberculosis complicated with kyphosis. Furthermore, the spinal cord was able to tolerate further vertebral shrinkage, and its length was not affected by the existing spinal cord shrinkage and kyphotic angle.