手术治疗脊柱结核37例

 目的 探索脊柱结核的治疗方法,提高脊柱结核的治愈率,减少复发.方法 手术治疗脊柱结核37例,采用病椎部分切除、大块髂骨植骨或者放置cage加上前路或者后路内固定.术后超短程化疗,定期复查,检测X线片及血沉.结果 随访20～36个月,平均30个月,1例术后出现肺不张,行胸腔积液清理术,1例于术后3周再次出现窦道,重新手术清除病灶.伴有神经症状的均有不同程度的好转,大多数患者血沉恢复正常.术后1年X线片显示植骨融合良好,均回到了工作岗位或者生活自理.结论 病椎部分切除、植骨融合、内固定治疗脊柱结核,卧床时间短,可早期活动,复发率低.

Operative treatment of spinal tuberculosis

Objective To search for a good method to treat spinal tuberculosis.Methods Thirty-seven patients with spinal tuberculosis were treated by partial excision of the affected vertebrae,large iliac strut graft and anterior or posterior internal fixation,followed by the ultrashort anti-tuberculosis chemo therapy.All the patients were checked by X-ray and ESR examination postoperatively.Results All patients were followed-up for 20-36 months with an average of 30 months.one case had a complication of pulmonary atelectasis,another one had a sinus about 3 weeks after operation and was reoperated on.Other patients had no complications.All patients' neurological symptoms improved to different extent after treatment The ESR declined to normal in most patients.The X-ray films taken 1 year after operation showed a good fusion.Conclusions Combination of patial excision of the affected vertebrae,bone graft,and internal fixation is an effective method to treat spinal tuberculosis.