微创技术在胸腰椎结核前路手术中的应用进展

在胸腰椎结核的手术治疗中,前方入路可以完成病灶清除、植骨融合及内固定术。传统的前路手术显露充分,病灶清除彻底,手术疗效肯定,但手术切口长、创伤大。近年来,微创技术因具有创伤小、恢复快等优势,在胸腰椎结核前路手术中的应用逐渐增多。作者复习文献,通过探讨改良小切口前路手术、影像学技术实时监控引导下经皮置管引流、内镜辅助下手术、通道下侧方椎间融合术等各种手术的最佳适应证,就微创技术在胸腰椎结核前路手术中的应用特点进行综述,相信对不同患者采用不同微创手术方式具有重要临床意义。

Research progress of anterior minimally invasive surgery in tuberculosis of the thoracic and lumbar spine

In the surgical treatment of thoracic and lumbar tuberculosis, debridement of the lesion, bone graft and internal fixation can be done via anterior approach. The traditional anterior approach has disadvantages of long incision and big trauma though the lesion can be clearly revealed and removed. In recent years, minimally invasive technology has been gradually used in anterior thoracic and lumbar tuberculosis surgery because of its advantages of small trauma, rapid recovery. We reviewed the literature and discussed the best indications of minimally invasive surgeries such as modified small incision anterior surgery, real-time imaging guided percutaneous catheter drainage, endoscopic assisted surgery and lateral intervertebral fusion. The application of minimally invasive techniques in anterior surgery of thoracic and lumbar tuberculosis was discussed in this review. It is of great significance to select different minimally invasive surgical procedures for different patients.