后路一期全脊柱切除治疗胸椎肿瘤和结核

目的探讨后路一期全脊椎切除＋椎弓根钉内固定系统治疗胸椎肿瘤和结核的临床疗效。方法 2009年1月~2010年6月,应用后路一期全脊椎切除、钛笼重建并后路椎弓根钉内固定系统治疗胸椎肿瘤患者5例,应用后路一期全脊椎切除、植骨并后路椎弓根钉内固定系统治疗胸椎结核患者2例。结果术后随访6~15个月,所有患者疼痛症状均消失,均无神经损害症状出现或者加重,平均恢复1.5级（Frankel分级）。均骨性融合,无内固定松动断裂。结论后路一期全脊椎切除＋椎弓根钉棒内固定系统治疗胸椎肿瘤和结核,创伤小,效果好,能有效重建脊柱稳定性,延长患者生存时间和提高患者生活质量。

One-stage posterior total vertebral resection in treatment of thoracic vertebrae tumor and tuberculosis

Objective To investigate the curative effect and superiority of one stage posterior total vertebral resection and internal fixator with pedicle of vertebral arch nail in the treatment of thoracic vertebrae tumor and tuberculosis.Methods From January 2009 to June 2010,five patients with thoracic vertebrae tumors were treated by the posterior total vertebral resection with titanium mesh cage and internal fixator with pedicle of vertebral arch nail.Two patients with thoracic vertebrae tuberculosis received the posterior procedure total vertebral resection with bone graft and internal fixator with pedicle of vertebral arch nail.Results All the patients were followed up for a period ranging from 6 to 15 months.All patients achieved relief of pain after surgery,and all the patients showed a postoperative neurologic improvement.By Frankel neurological classifications,all patients were improved by 1.5 grades on average.All the patients showed bony fusion after 6 months,and no internal fixation loosening or breach was found.Conclusion It is a feasible and effective to treat thoracic vertebrae tumor and tuberculosis by one stage total vertebral resection and internal fixator with pedicle of vertebral arch nail.Compared with combined anterior and posterior procedure,this surgical technique may decrease injuries and has satisfactory result.The treatment can reconstruct the spinal stabilization.The survival time and the life quality of patients have been greatly improved.