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Year : 2018  |  Volume : 5  |  Issue : 1  |  Page : 10-17

Conservatively treated spinal tuberculosis in children: Ambulatory chemotherapy

Surgeon, Department of Orthopedic Surgery and Traumatology, Cheju Halla General Hospital, Jeju Province, Republic of Korea

Correspondence Address:
Myung-Sang Moon
Surgeon, Department of Orthopedic Surgery and Traumatology, Cheju Halla General Hospital, Jeju Province
Republic of Korea
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Source of Support: None, Conflict of Interest: None

DOI: 10.5005/jp-journals-10039-1162

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Introduction: To assess the chronological changes of the disease-related kyphosis after chemotherapy alone, and secondly to clarify the role of growth cartilage in the healed lesion on kyphosis change. Materials and methods: A total of 101 children with spinal tuberculosis in various stages of disease processes, aged 2 to 15 years, were the subject materials. They were treated with two different chemotherapy formulas; before 1975, 18 months of triple chemotherapy [isoniazid (INH), paraaminosalicylic acid (PAS), and Streptomycin], and from 1976, 12 months of triple chemotherapy (INH, rifampicin, ethambutol, or pyrazinamide). By utilizing the images, the effects of the remaining growth plate cartilage on chronological changes of kyphosis after the initiation of chemotherapy were analyzed. The first assessment at postchemotherapy was at 1 year and at the final discharge time from the follow-up. Results: Complete disk destruction at the initial examination was observed in 2 (5.0%) out of 40 cervical spine, 8 (26.7%) out of 30 dorsal spine, and 6 (19.4%) out of 31 lumbosacral spine. In those cases, kyphosis developed inevitably. In the remainders, the disks were partially preserved or remained intact. Among 101 children, initial kyphosis was maintained in 20 (19.8%), while kyphosis decreased in 14 (13.7%) children, and increased in 67 (66.3%) children with nonrecoverably damaged growth plate. Conclusion: It was possible to predict the fate of the kyphosis at the time of initial treatment, but its predictive accuracy was low. Therefore, finally, it is recommended to be done at the end of chemotherapy. In children, the kyphotic deformity assessment should be continued till the maturity

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