前路病灶清除同期植骨内固定治疗胸腰椎结核

目的探讨前路病灶清除同期植骨内固定治疗胸腰椎结核的临床疗效。方法回顾分析我院2006年1月至2009年1月经前路病灶清除同期植骨内固定治疗胸腰椎结核患者26例,观察术后脊髓神经功能恢复、脊柱后凸畸形矫正、结核中毒症状的改善及脊柱的稳定性情况。结果所有患者均获得随访,时间6～36个月,平均随访18个月,胸腰背部疼痛及结核中毒症状消失,内固定位置良好,无松动、断裂等并发症,术后平均5个月植骨均获得骨性融合。术前Cobb角18.5°～56.0°,平均27.3°,术后1周及末次随访时Cobb角平均15.2°、17.6°,平均矫正12.1°,脊髓神经功能不同程度得到恢复。结论前路病灶清除同期植骨内固定治疗胸腰椎结核病灶清除彻底,脊髓减压全面,可有效矫正后凸畸形,术后即刻重建脊柱稳定性,是胸腰椎结核较安全有效的治疗方法 。

One-stage anterior debridement and interbody autograft combined with internal fixation for treatment thoraco-lumbar spinal tuberculosis

Objective To investigate the effect of one-stage anterior debridement and interbody autograft combined with internal fixation for treatment thoraco-lumbar spinal tuberculosis.Methods From January 2006 to January 2009,26 patients who had been treated for thoraco-lumbar spinal tuberculosis by the mean of one-stage anterior debridement and interbody autograft combined with internal fixation.To study the spinal cord function、angle of kyphosis and stability of spine.Results Follow-up lasted for 6 to 36 months（average 18 months）,tuberculosis symptoms with chest-back pain vanished,no instrument failure was noted,spinal fusion was documented after operation 5 months.The pre-operation Cobb’s angle was 18.5°-56°（average 27.3）,after operation one week,the average Cobb’s angle was 15.2°,at the last follow-up,the average Cobb’s angle was 17.6°,the average rectification was 12.1°,the function of spinal cord recovered partly.Conclusion One-stage anterior debridement and interbody autograft combined with internal fixation for treatment thoraco-lumbar spinal tuberculosis can eliminate the tuberculosis radically,decompression overall,rectificate kyphosis,reconstruct stability of spine instantly,it was a safe and effect treatment.