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Fig. 2 | BMC Musculoskeletal Disorders

Fig. 2

From: Two-stage treatment for severe spinal kyphotic deformity secondary to tuberculosis: halo-pelvic traction followed by a posterior-only approach correction

Fig. 2

A 31-year-old male presented with a 17-year history of tuberculous angular kyphosis. The patient complained of back pain, difficulty breathing, and weakness of both lower extremities (ASIA D). Preoperative CT demonstrated extensive fusion of the vertebral bodies from T6-T12, and MRI showed the spinal cord had been drawn into the angular kyphosis region. After 12 weeks of HPT, the kyphosis angle decreased from a pre-traction value of 145° to a post-traction value of 87°. CT showed an abruption at the distal end of the kyphosis (between L1 and T12); however, neurological symptoms did not become worse. Posterior decompression, pedicle screw fixation (T1-L4), PSO, and autologous bone grafting were performed via a posterior approach to achieve final correction. Postoperatively, the kyphosis angle was 75°. By 3 months after the operation, the patients breathing difficulty and back pain were completely relieved. The numbness in the lower extremities gradually diminished and was resolved by 6 months after the operation (ASIA E). The red arrow showed the orientation of the traction force

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