Spinal tuberculosis in children: a retrospective study of 112 cases

English Keywords:Tuberculosis  Spine  Children  Kyphosis  Paralysis

English Abstract:

  【Abstract】 Objectives: To analyze the clinical characteristics of children with spinal tuberculosis(TB), and to provide references for its diagnosis and therapy. Methods: A retrospective analysis of 112 children with spinal TB from January 2006 to December 2012 was carried out, the first complaint, duration, the segments involved, the number of vertebrae involved, the kyphotic Cobb angle and paralysis were reviewed. The correlation between duration, the number of vertebra involved and the kyphotic Cobb angle were analyzed. At the same time, the patients were divided to infant group(0-3 years), preschool children group(4-6 years), school-age children group(7-12 years) and juvenile group(13-17 years). The spine was divided into upper spine(cervical, thoracic and cervicothoracic segment) and lower spine(thoracolumbar, lumbar, lumbosacral and sacral segments). The morbidity of both upper and lower spine was compared. According to the neurological function, the patients were divided into paralysis group and non-paralysis group. The duration, number of vertebra involved and kyphotic Cobb angle of between two groups were compared. According to the kyphotic Cobb angle, the patients were divided into no less than 30° group and less than 30° group. The morbidity of paralysis were compared between two groups. Results: In these patients, pain was the most common first complaint and thoracic segment involved was most common. The average disease duration and number of vertebras involved was 5.3±10.9 months and 2.9±1.0 respectively. The average kyphotic Cobb angle was 15.7°±17.0°. Significant correlations were found for the kyphotic Cobb angle, the number of vertebrae involved and duration(r=0.384-0.666, P<0.05). There was significant difference between paralysis group and non-paralysis group with regard to the kyphotic Cobb angle, the number of vertebrae involved and duration(P<0.05). There was significant difference between the group with the kyphotic Cobb angle of no less than 30° and the group with kyphotic Cobb angle of less than 30° in regard to the paralysis rate(61.1% and 17.1%, respectively). There was significant difference among the four different age children groups with regard to the rate of pain and paralysis in the first complaint(P<0.05）. The paralysis rate of infant and preschool children groups was obviously higher than that of school-age children and juvenile groups(42.1%, 25.8%, 10.3% and 13.0%, respectively). No significant difference was found among the four age children groups with regard to duration, the morbidity of upper and lower spinal segment, number of vertebrae involved, kyphotic Cobb angle(P>0.05). Conclusions: Pain was the most common first complaint and thoracic segment was most common segment involved in children with spinal TB. Significant correlations were found among the kyphotic Cobb angle, the number of vertebra involved and duration. There was significant difference between paralysis group and non-paralysis group in regard to the kyphotic Cobb angle, the number of vertebra involved and duration. The paralysis rate of infant and preschool children or the kyphotic Cobb angle of no less than 30° was higher.