Clinical Effectiveness of Treatment of Children Afflicted by Lumbar Tuberculosis With Posterior-only Approach Using Poly-ether-ether-ketone Cage Combined With Single-segment Instrumentation

Abstract

Background: We sought to investigate the clinical outcomes of posterior-only approach using poly-ether-ether-ketone (PEEK) cage combined with single-segment instrumentation in the treatment of lumbar tuberculosis in children.Methods: Between February 2008 and August 2017 in our hospital, 18 children with single-segment lumbar tuberculosis were enrolled in this study. Children were treated by a posterior-only approach using PEEK cage combined with single-segment instrumentation. Medical records and radiographs were retrospectively analyzed. Visual analogue scores (VAS) were used to evaluate measures of quality of daily life. Criteria defined from the American Spinal Injury Association (ASIA) were used to evaluate measures of neurological function.Results: Mean follow-up time was 54.6 ± 12.1 months (39–84 months). No severe complications were noted to have occurred. Measures indicated there was satisfactory bone fusion for observations for all patients. Mean Cobb angles were significantly decreased from the mean preoperative angle (19.8° ± 13.1°) to those both postoperatively (-4.9° ± 7.6°) and at final follow-up (-3.5° ± 7.3°) (both P < 0.05), with a mean angle loss of 1.7° ± 0.9°. Th erythrocyte sedimentation rate (ESR) returned to normal levels for all patients within 3 months postoperatively. All patients had significant postoperative improvement in respect to neurological performance and VAS scores.Conclusions: The posterior-only approach using PEEK cage combined with single-segment instrumentation was found to be an effective and feasible treatment option for children with lumbar tuberculosis. Such procedures can likely be used to help patients by facilitating reconstruction of spinal stability, and increasing retainment of lumbar mobility in conjunction with reduced invasiveness compared to counterpart treatments.