Ⅰ期病灶清除植骨融合加内固定术治疗胸腰段结核158例疗效分析

目的探讨Ⅰ期病灶清除植骨融合加内固定术治疗胸腰段结核的疗效分析。方法回顾性分析评价:采用I期病灶清除植骨内固定术治疗胸腰段结核158例,男97例,女61例,经2周中西医结合正规抗结核治疗后Ⅰ期行病灶清除植骨融合加内固定术,术后继续中西医结合抗结核1～1.5年,计算患者术前、术后1周及末次随访时Cobb角,采用配对t检验进行统计学分析。分析术前与术后脊髓神经功能Frankel分级情况。结果术后随访1～2.5年,平均18个月,158例患者无局部复发及窦道形成,术前与术后Cobb角差异有统计学意义。Frankel分级除2例A级无变化外,其余均有1～2级恢复。结论针对性抗结核治疗是脊柱结核治疗的关键,病灶清除植骨融合内固定治疗胸腰段脊柱结核安全有效。

Clinical Effect of Anterior Debridement, Bone Graft and Internal Fixation in the Treatment of 158 Thoraciclumbar Spinal Tuberculosis

Objective Investigate the efficacy analysis of Phase Ⅰ of the debridement and fusion and internal fixation for the treatment of thoracolumbar tuberculosis.Methods Retrospective analysis and evaluation： Phase I debridement and internal fixation for thoracolumbar tuberculosis in 158 cases,male 97 cases,female 61 cases,the Phase Ⅰ line debridement and fusion Integrative formal anti-TB treatment after two weeksand internal fixation,postoperative continue Integrative antituberculous 1 to 1.5 years in patients with surgery,one week after the last follow-up Cobb angle,using the paired t test was used for statistical analysis.Analysis of preoperative and postoperative spinal cord nerve function Frankel grade.Results Were followed up for 1 to 2.5 years,an average of 18 months,158 patients with local recurrence and sinus formation,preoperative and postoperative Cobb angle difference was statistically significant.The Frankel grade except two cases of A-level did not change,the rest have 1 to 2 Recovery.Conclusion Targeted anti-TB treatment is the key to the treatment of spinal tuberculosis,debridement and fusion with internal fixation of thoracolumbar spinal tuberculosis safe and effective.