胸腰椎结核后路病灶清除一期植骨融合内固定术的疗效分析

目的 探讨后路病灶清除一期内固定治疗胸腰椎结核的临床疗效.方法 对1999年1月至2008年9月间55例脊柱结核患者采用病灶清除、TRSH固定,男29例,女26例,年龄20～77岁,平均39岁.病变节段胸椎30例,腰椎27例.胸腰联合4例.所有患者均有不同程度的后凸畸形,Cobb角(40±3)°,10例伴有不完全截瘫.Frank A级1例,B级7例,C级17例.所有患者术前4-8周的正规的抗结核治疗.结果 术后55例均获得随诊,术后随访0.5～9年,平均2年,术后有1例患者术后出现切口窦道,扩创后愈合.并发急性肺不张1例,经对症处理愈合.结论 经后路病灶清除一期内固定治疗脊柱结核可以很好地清除病灶,脊髓及神经根减压、植骨融合稳定,矫正畸形,提高脊柱结核的治愈率.

Radical debridement and single stage posterior spinal fusion and instrumentation for the treatment of thoracic-lumber tuberculosis

Objective To evaluate the radical debridement and single stage posterior spinal fusion and inatrumentation for the treatment of spinal tuberculosis. Methods From 1999 to 2004,57 patients(29 males,26 females)with spinal tuberculosis were operated at our department. The age range was 20 to 77 years old(mean:39 years old).There were 30 cases of thoracic vertebra and 27 cases of lumbar vertebra All the patients received a standard pre-operative 4-8-week anti-tuberculosis treatment. Results The followup period ranged from 1-4 years and 95.9%of patients achieved an excellent outcome. Solid bony fusion was seen at last in all cases.The mean post-operative kyposis angle reduced to 20°from 32°pre-operation.Conclusion Single stage anterior spinal fusion and instrumentation iS curative for spinal tuberculosis.