Characteristics | Patient 1 | Patient 2 |
Age | 21 mo | 23 mo |
Symptoms | General state deterioration, hypoactivity, poor appetite, neck tilt, and abdominal pain | General deterioration and limp |
Involved spine segments | T3-T4 | T8 |
Antitubercular treatment | RIF + INH + PZA + EMB | |
Preoperative sagittal Cobb | T2-T5 34° | T5-T10 48° |
Surgical procedure | Costotransversectomy + debridement + T3 T4 corpectomy + anterior structural rib autograft + T2 T6 PSF | Thoracotomy + anterolateral debridement and decompression + T8 corpectomy + anterior structural rib autograft |
Postoperative complications | Meningitis (VPD), anti-TB hepatotoxicity, progressive kyphosis, and screw pull-out | Kyphosis, without progression after the first year |
Reintervention | 3-column OT + anterior fibular allograft + posterior T1-T7 fixation | None |
Follow-up | 36 mo | 48 mo |
AFB, acid-fast bacilli; EMB, ethambutol; INH, isoniazid; OT, osteotomy; PSF, posterior spinal fusion; PZA, pyrazinamide;RIF, rifampicin; TB, tuberculosis; VPD, ventriculoperitoneal derivation.