一期前后联合入路治疗胸腰段脊柱结核

目的回顾性分析一期后路椎弓根螺钉内固定和前路病灶清除植骨融合术治疗胸腰椎脊柱结核的临床疗效。方法 2004年12月～2010年8月,采用一期后路椎弓根螺钉系统内固定和前路病灶清除、神经减压、自体骨椎间植骨治疗胸腰段脊柱结核患者27例,2个椎体16例,3个椎体8例,4个椎体2例,5个椎体1例。分析术前与术后脊髓神经功能Frankel分级情况以及脊柱融合情况。结果所有患者术后随访9个月～3年,平均16.5个月。脊柱后凸畸形由术前平均46.3°改善到术后平均14.3°(P<0.05)。术后所有病例神经功能均获得改善。结论经后路椎弓根螺钉内固定和前路病灶清除植骨融合术治疗脊柱结核能彻底清除结核病灶,矫正脊柱后凸畸形,促进脊髓及神经功能恢复。

Combined anterior and posterior surgeries for treatment of thoraciclumbar spinal tuberculosis

Objective To investigate the clinical results of combined anterior and posterior surgeries for treatment ofmultipIe-segraent thoraciclumbar spinal tuberculosis. Methods From December 2004 to August 2008 ,27 patients treated by combined anterior and posterior surgery were reviewed retrospectively. Two vertebral bodies involved in 16 cases, 3 vertebral bodies in 8 cases, 4 vertebral bodies in 2 eases, and 5 vertebral bodies in 1 cases. All of the 27 cases showed neurological deficit before surgery. Calculated the preoperation and toperation kyphosis Cobb＇ s angle of the patients and analyze the preoperation and pestoperation neurological function in Frankel classification. Results The postoperation follow-up time was 10 months-3 years, average 16.5 months. Kyphotic deformity improved in all 27 patients （46.3° venus 14.3° ） with the aver- age correction angle of 14.3° （P 〈0. 05 ）. All cases acquired improvement in neurological function. The average fusion time was 6 months （range 3-10 months）. There were no evident surgical complications. Conclusion One stage combined anterior and posterior sur~＇ies for treatment of multiple-segment thoraeiclumbar spinal tuberculosis can get satisfactory out- come and correction of the kyphosis deformity.