To evaluate the efficacy and safety of Halo-pelvic ring traction in the treatment of severe kyphotic deformity secondary to spinal tuberculosis.Eighty patients with severe kyphotic deformity due to spinal tuberculosis were included in the study. Forty of those patients (experimental group) received Halo- pelvic ring traction before surgery and the rest (control group) received surgical treatment directly. Two groups were compared by means of the duration of surgery, intraoperative blood loss, correction of Cobb angle, change in patient height, and American Spinal Injury Association (ASIA) impairment scale.Halo-pelvic traction group achieved significantly (P < .05) better results than direct surgical treatment group by means of the time of surgery (244 ± 58 minutes vs 276 ± 47 minutes, P = .036), intraoperative blood loss (950 ± 236 mL 1150 ± 305 mL, P = .018), correction of Cobb angle (68.3 ± 12.6 vs 55.6 ± 13.8, P = .001), change in patient height (9.4 ± 4.0 cm vs 6.8 ± 3.8 cm, P = .024). The mean improvement of ASIA scale was more in the experimental group than in the control group (0.23 ± 0.07 vs 0.15 ± 0.06); however, the difference is not statistically significant (P = .09).Halo-pelvic ring traction before osteotomy can be applied in patients with severe spinal kyphotic deformity due to spinal tuberculosis to increase efficacy and safety of surgical treatment.
Background: As a common traumatic disease in spine surgery, thoracolumbar burst fractures (TLBF) often leads to complications such as back pain, kyphotic deformity and nerve damage, causing severe physical defects and economic burden on patients. Objective: To explore kyphotic deformity correction of different operative approaches for TLBF. Design of research: Systematic review and meta-analysis are utilized to compare the efficacy of different approaches for postoperative kyphotic deformity in TLBF patients. Methods: English documents that discussed TLBF with different operative approaches were searched from various databases. The obtained documents were screened and evaluated. Results: The comparison and analysis of preoperative Cobb angle, early-postoperative Cobb angle correction, and follow-up Cobb angle correction between the anterior and posterior approach groups showed no statistical significance [MD=0.97, 95% CI (-0.44, 2.38), P=0.18; MD=0.25, 95% CI (-0.04, 0.54), P=0.10; MD=-0.12, 95% CI (-0.44, 0.19), P=0.45]. Conclusion: While treating TLBF symptoms, both the anterior and posterior approaches were effective in correcting postoperative kyphosis deformity. Therefore, while determining a treatment method, the age and the tolerance to the surgery of each patient should be considered for the surgical treatment options. This study provides new ideas for clinical treatment of TLBF in the future.
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