单纯后路减压病灶清除内固定治疗伴神经损害的胸椎结核

目的评价一期后路减压、病灶清除并椎弓根螺钉内固定治疗伴有神经损害的胸椎结核的临床疗效。方法回顾性分析2001年1月～2011年12月收治的病灶单发、位于胸椎且伴有神经损害的脊柱结核患者共22例,行一期后路减压、病灶清除并椎弓根螺钉内固定。术前神经功能Frankel分级B级2例,C级6例,D级14例。记录手术时间、术中出血量、术前术后神经功能改善情况及临床结核治疗情况。结果术后平均随访24.7个月,治愈率95.5%,神经功能改善率81.8%,术后神经功能与术前相比差异具有统计学意义（P〈0.05）。结论一期后路减压、病灶清除并椎弓根螺钉内固定对于合并有神经损害的胸椎结核患者是一种安全有效的治疗方法。

Posterior decompression, radical debridement and internal fixation in treatment of thoracic spinal tuberculosis with nervous damage

Objective To evaluate the therapeutic effect of single-stage posterior decompression,debridement and pedicle screw fixation for the thoracic spinal tuberculosis with neurological deficit.Methods A consecutive series of 22 cases of thoracic spinal tuberculosis with neurological deficit from January 2001 to December 2011 were studied retrospectively.All the patients underwent single-stage posterior decompression,debridement and pedicle screw fixation.According to Frankel classfication system,2 cases were classified as grade B,6 case as grade C,and 14 cases as grade D.The operation time,blood loss,neurological function and clinical condition were recorded.Results The average duration of follow-up was 24.7 months.The cure rate was 95.5%.The improvement rate of neurological function was 81.8%,and there was significant difference of the neurological function before and after operation(P<0.05).Conclusion Single-stage posterior decompression,debridement and pedicle screw fixation is a safe and effective method for the patients with thoracic spinal tuberculosis and nervous damage.