Abstract
Introduction: The progress of post tubeculous kyphosis in children during ‘growth spurt’ is unpredictable and has not been clearly documented in literature.
Methods: The progression of deformity in 63 children treated conservatively and belonging to a controlled clinical trial was studied over 15 years.
Results: The average Kyphosis increased from 35.2 degrees to 41.3 degrees in the ‘Active Stage’ (Phase I), there was an increase in all patients. In the ‘Healed stage’ (Phase II), a variable progress continued which was more prominent during the ‘growth spurt’. In Type I, there was a worsening which occured either continuously (Type 1a; n=19.30%), or suddently after a gap of few years (Type 1b;n=6.9%). In Type II, an improvement occured either after an initial increase or a plateau (Type IIa; n=18.29%), or continuously after disease cure (Type IIb; n=9.15%). In Type III, the deformity was static (n=11.17%). The average increase in Type Ia was 24.2 degrees, Type IIb was 20;5 degrees, Type Ib was 58.4 degrees; the decrease in Type IIa was 4.9 degrees, Type IIb was 20.5 degrees and the decrease in Type III was 1.7 degrees. Overall, the growth spurt sresulted in an increase in deformity in 25 (39%) children, a decrease in 27 (44%) and no change in 11 (17%).
Conclusion:
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Post-tuberculous kyphosis in children is a ‘Dynamic deformity’ which changes till skeletal maturity.
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Children must not be discharged after disease cure and yearly follow up to monitor deformity is mandatory.
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Surgical intervention to prevent late profress will be needed in one third of children.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
