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KMID : 0361620170520010073
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Journal of the Korean Orthopaedic Association
2017 Volume.52 No. 1 p.73 ~ p.82
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Spinal Tuberculosis in Children: Predictable Kyphotic Deformity after Cure of the Tuberculosis
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Moon Myeong-Sang
Kim Dong-Hyeon
Kim Sang-Jae
Moon Han-Lim
Kim Sung-Soo
Kim Sung-Sim
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Abstract
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Purpose: To assess the chronological changes of disease-related kyphosis after chemotherapy alone.
Materials and Methods: A total of 101 children aged 2 to 15 years with spinal tuberculosis, accompanied by various stages of disease processes were enrolled for analysis. By utilizing the images in them, the growth plate condition and chronological changes of kyphosis after chemotherapy were analyzed at two points in time; the first assessment was at post-chemotherapy one-year and second at the final discharge.
Results: Complete disc destruction in the cervical, dorsal and lumbosacral spines was observed in 2 out of 40 children (5.0%), 8 out of 30 children (26.7%), and 6 out of 31 children (19.4%), respectively. In those cases, the residual kyphosis inevitably developed. In the remaining children, the discs were intact or partially damaged. Among the 101 children kyphotic deformity was maintained without change in 20 children (19.8%). Kyphosis decreased in 14 children (13.9%), while it increased in 67 children (66.3%) with non-recoverably damaged growth plate.
Conclusion: Although it is tentatively possible to predict the deformity progress or non-progress and spontaneous correction at the time of the initial treatment, its predictive accuracy is low. Therefore, assessment of the chronological changes should be performed at the end of chemotherapy. In children with progressive curve change, assessment of deformity should be continued until maturity.
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KEYWORD
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tuberculosis, spine, child, kyphosis, chemotherapy
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