%0 Journal Article
%T Pott¡¯s Disease in a 2-Year-Old Child Treated by Decompression and Anterior-Posterior Instrumented Fusion
%A Mehmet Nuri Erdem
%A Cem Sever
%A Mehmet Fatih Korkmaz
%A Sinan Karaca
%A Ferit Kirac
%A Mehmet Tezer
%J Case Reports in Orthopedics
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/252973
%X Introduction. Paraplegia and kyphotic deformity are two major disease-related problems of spinal tuberculosis, especially in the early age disease. In this study a 2-year-old boy who underwent surgical decompression, correction, and 360¡ã instrumented fusion via simultaneous anterior-posterior technique for Pott¡¯s disease was reported. Case Report. A 2-year-and-9-month-old boy presented with severe back pain and paraparesis of one-month duration. Thoracic magnetic resonance imaging demonstrated destruction with a large paraspinal abscess involving T5-T6-T7 levels, compressing the spinal cord. The paraspinal abscess drained and three-level corpectomy was performed at T5-6-7 with transthoracic approach. Anterior instrumentation and fusion was performed with structural 1 autogenous fibula and rib graft using screw-rod system. In prone position pedicle screws were inserted at T4 and T8 levels and rods were placed. Six months after surgery, there was no weakness or paraparesis and no correction loss at the end of follow-up period. Discussion. In cases of vertebral osteomyelitis with severe anterior column destruction in the very early child ages the use of anterior structural grafts and instrumentation in combination with posterior instrumentation is safe and effective in maintenance of the correction achieved and allows efficient stabilization and early mobilization. 1. Introduction Spinal tuberculosis, the most common pattern of extra pulmonary tuberculosis, also has increased rapidly around the world in recent years, especially in the undeveloped and developing countries [1]. Paraplegia and kyphotic deformity development are two major disease-related problems. Medical and surgical decompression (antituberculous treatment and debridement) and early reconstruction of spinal stability plays an important role in the surgical management of spinal tuberculosis [2, 3]. The reported techniques of surgical treatment range from anterior debridement and interbody fusion [4, 5] and debridement and internal fixation from the posterior approach [6] to combined single-stage or two-stage posterior instrumentation with anterior debridement and bone grafting [7¨C14]. Recently decompression, fusion, and instrumentation by simultaneous posterior-anterior-posterior surgery are recommended for effective kyphosis correction and early ambulation [15]. In this study a 2-year-old boy who suffered from severe paraparesia and back pain was reported. The aim of this case report is to verify the importance of early reconstruction of spinal stability and the technique of 360¡ã fusion via
%U http://www.hindawi.com/journals/crior/2014/252973/