Ⅰ期前后方融合后路内固定治疗胸腰椎结核

目的：探讨胸腰椎结核Ⅰ期前后方融合、后路内固定治疗的临床疗效。方法：自2003年3月至2006年12月,应用Ⅰ期前后方融合后路内固定治疗胸腰椎结核23例,男15例,女8例;年龄17～61岁,平均37.6岁。结核病灶位于胸段4例,胸腰段8例,腰段11例。结果：术后随访9～40个月（平均28.7个月）,患者术后2～3周症状基本缓解并下床活动,术后6个月X线片显示植骨融合。16例不完全性截瘫患者Frankel分级平均恢复1.62级。并发症主要有暂时性窦道形成2例,内固定断裂1例,因抗结核化疗周期不足复发1例。结论：Ⅰ期前后方融合后路内固定治疗胸腰椎结核能有效地清除病灶、重建脊柱稳定性、促进植骨融合和截瘫恢复。

One stage anterior and posterior fusion and posterior fixation for the treatment of thoracic and lumbar spinal tuberculosis

Objective: To evaluate the clinical effect of one stage anterior and posterior fusion and posterior fixation for the treatment of thoracic and lumbar spinal tuberculosis. Methods: From March 2003 to December 2006,one stage anterior and posterior fusion and posterior fixation were performed to treat 23 patients who suffered thoracic and lumbar spinal tuberculosis. There were 15 males and 8 females with an average of 37.6 years(17-61 years). 4 cases' tuberculose focus were in thoracic vertebra,8 cases in thoracolumbar,11 cases in lumbar. Results: The average follow up period was 28.7 months(9-40 months). The symptoms of all patients had primarily relieved and the patients can ambulate at 2-3 weeks after treatment. At the 6th after operation, the X-ray showed interbody fusion. Frankel grading of 16 patients with incomplete paraplegia were improved averagely 1.62 grades. The major complications including 2 cases of temporary sinus formation,1 case of fixtor breaking and 1 case of recurring(owing to an inadequate postoperative chemotherapy). Conclusion: One stage anterior and posterior fusion and posterior fixation can effectually resect focus,rebuild stability of spine,promote interbody fusion and recovery of incomplete paraplegia in treating thoracic and lumbar spinal tuberculosis.