LAUSR

PURPOSE Spinal osseous tuberculosis (Pott's spine), though very common in endemic countries, has a less incidence in very young children. However the infection has the propensity to cause greater vertebral destruction in this age group leading to severe structural kyphotic deformity and associated neurological deficit. We describe the case of a 1 year7 month old child with severe tubercular kyphotic deformity of upper thoracic spine managed with posterior Vertebral Column Resection (VCR) and non-fusion posterior pedicle screw instrumentation. METHODS Case report and review of literature RESULTS: A 19month old boy presented with 1 month history of spontaneous onset, progressive painful rigid kyphotic deformity of upper back associated with spastic paraparesis with bowel and bladder incontinence. The Magnetic resonance imaging (MRI) showed severe destruction of bodies of D4 to D7 vertebrae with cord edema and draping of spinal cord over the internal gibbus at D4-7.He was operated with a restricted anterior fusion via single stage posterior VCR D4 -7 with non-fusion pedicle screw instrumentation from D1 to D9 with subsequent extension of instrumentation to D10 after 4 months. . CONCLUSION Multi-level posterior VCR with a restricted fusion and non -fusion pedicle screw instrumentation beyond the resection site, can be safely done in young children (<3years) requiring rigid tubercular kyphotic deformity correction. However these patients are to be regularly followed up and may require multiple surgeries.