Ⅰ期病灶清除植骨融合内固定术治疗胸腰椎结核43例疗效观察

目的观察Ⅰ期病灶清除植骨融合内固定术治疗胸腰椎结核的临床疗效。方法回顾性分析2002年6月～2008年6月期间采用Ⅰ期病灶清除植骨融合内固定术治疗的胸腰椎结核病患者,分析其症状及截瘫改善、后凸畸形矫正和植骨融合情况。结果所有患者均获得随访,平均随访3.6±1.5 a;所有患者症状均明显改善,8例合并截瘫的患者中,5例完全恢复正常。3例ASIA分级改善1～3级;植骨均在术后0.5～2 a融合,治愈率58.08%,好转率18.58%,后凸Cobb角平均矫正25.7°。结论Ⅰ期病灶清除植骨融合内固定术可有效治疗胸腰椎结核,并能同时矫正胸腰椎后凸畸形,临床疗效满意。

Clinical Observation about Debridement and Fusion with Internal Fixation to Treat Thoraco-Lumber Spinal Tuberculosis

Objective To evaluate the clinical result about debridement and fusion with internal fixation to treat thoraco-lumbar spinal tuberculosis. Methods 43 cases suffered from thoraco-lumbar spinal tuberculosis between June 2002 and September 2008 managed by one-stage transpedicular screw system internal fixation and anterior debridement and autograft fusion were reviewed retrospectively. All cases were involved in a longitudinal study with a following-up of 3.6 （ 1.5 - 6 ） years. Results All patients showed evidence of successful autograft fusion in 6 months to no more than 2 years. Among 8 cases of Port＇S paraplegia,5 recovered completely,3 recovered partly with 1 -3 grades of improvement according to ASIA score system. Total ratio of recovery was 58.08%. The average immediate postoperative correction angle was 25.7°. Conclusion One-stage transpedicular screw fixation and debridement and bone fusion of thoraco-lumbar spinal tuberculosis can provide successfully interbody fusion and guarantee excellent clinical outcome.