手术结合药物治疗16例颈椎结核患者的效果分析

目的 对成人颈椎结核外科手术结合药物治疗的临床疗效进行分析。 方法 选取2007年5月至2010年3月下颈椎结核行手术结合药物治疗的患者16例，对其治疗手段及其疗效进行回顾性分析。 结果 平均随访21个月，结核病灶愈合，植骨块融合，所有患者术后颈部疼痛等症状消失或明显改善。10例患者术后1周内肌力有较快的恢复，6例患者术后1个月内感觉、运动逐渐好转，所有患者大小便功能均在术后1个月内改善。Frankel分级提高1～3级，1例Frankel分级B级和1例Frankel分级C级患者术后恢复达D级，其余皆恢复到E级。 结论 手术结合药物治疗颈椎结核合并四肢瘫，早期效果满意。由于临床应用时间短，远期疗效有待观察。

Efficacy of combination of surgery with drug therapy for 16 cases with cervical tuberculosis

Objective To evaluate the clinical effects of surgery combined with drug therapy for cervical tuberculosis. Methods From May 2007 to March 2010, 16 cases who suffered from cervical tuberculosis were treated by surgery combined with drug and the data of treatment and efficacy were retrospectively analyzed. Results The mean followed-up time was 21 months.All cases’ tuberculosis lesions were cured, bone graft got fusion,and clinical symptoms such as neck pain disappeared or was significantly improved. The muscle strength of 10 cases recovered in one week after operation, the sensory and motor function of 6 cases gradually improved in one month after operation, the bowel and bladder function of all patients were improved within one month after surgery. Their nerve symptoms were greatly improved. The level were improved from 1 to 3 grades in Frankel grading system. One patient with Frankel B was improved to D and another one was improved from C to D.The others with different Frankel grades were improved totally to E. Conclusion Surgery combined with drug therapy for cervical tuberculosis with quadriplegia are satisfactory in early stage. The long-term efficacy remains to be seen due to the short time of the clinical application.