前路内固定治疗胸腰椎结核伴后凸畸形与截瘫

目的：探讨前路植骨内固定治疗胸腰段脊柱结核伴后凸畸形与截瘫的疗效。方法：1996年～2002年4月采用前路病灶清除，植骨内固定治疗胸腰椎结核伴后凸畸形与截瘫62例，观察术后植骨融合、畸形矫正、截瘫恢复及结核病灶愈合情况。结果：平均随访2年2个月，56例患者获访，平均融合时间为3．6个月。骨性融合率100％。在胸段、胸腰段及腰段后凸畸形分别平均纠正29°、15°及9°，随访时无矫正度丢失；伴截瘫者11例，Frankel神经功能平均恢复2级；本组脊柱结核均治愈。结论：一期前路病灶清除植骨内固定，融合时间短，畸形矫正效果好，减压彻底，有利于截瘫恢复。

Anterior Internal Fixation for Treatment of Thoraculumbar Tuberculosis with Kyphosis and Paraplegia

Objective： To review the efficacy of anterior focus clearance and internal fixation far treatment of tho-racolumbar tuberculosis with kyphosis and paraplegia. Methods： A total of 62 patients with thoracic and/or lumbar tuberculosis underwent anterior focus clearance, bone grafting and internal fixation from 1996 to April 2002. Results： 56 of the 62 patients were followed up for 26 months, the fusion time was mean 3.6 months, with 100% of fusion rate. Kyphosis deformity in thoracic, thoracolumbar and lumbar segments was corrected for mean 29°, 15° and 9° respectively. No correction lost was noted. Neurological function has improved for mean 2 grades in 11 patients with paraplegia. Conclusion： Patients with tuberculosis of thoracic and/or lumber spine, primary anterior focus clearance, bone grafting and internal fixation have the advantages of short fusion time, good correction of deformation, and complete decompression.