后路经肌间隙侧方病灶清除植骨椎弓根钉内固定术治疗单间隙胸腰椎结核疗效观察

目的探讨一期后路经肌间隙侧方病灶清除植骨椎弓根钉内固定术治疗单间隙胸腰椎结核的疗效。方法回顾性分析自2009—05—2011-05诊治的32例单间隙胸腰椎结核，采用后路经肌间隙侧方行病灶清除、植骨融合、椎弓根钉矫形内固定治疗，并评价其疗效。结果32例术后、末次随访与术前比较Frankel分级有显著提升（P〈0．01）。后凸畸形平均矫正18°（P〈0．05），末次随访平均丢失角度2°（P〉0．05）。末次X线片显示腰椎融合率100％，未见假关节、内固定失败及复发。末次ODI评分平均（12±1．5）％，较术前有显著改善（P〈0．01）。结论后路经肌间隙侧方病灶清除植骨内固定术治疗单间隙胸腰椎结核是一种安全有效的治疗方法。

Clinical observation for single-interspace thoracolumbar tuberculosis treated with posterior lateral debridement and bone grafting and pedical-screw fixation through posterior muscle clearance

Objective To explore the effect of posterior lateral debridement and bone grafting and pedicalscrew fixation through posterior muscle clearance for treatment of single-interspace thoracolumbar tuberculosis by means of. Methods From May 2009 to May 2011,32 patients suffering single-interspace thoraeolumbar tuberculosis underwent posterior lateral debridement and interbody bone graft and pedieal-screw fixation through posterior muscle clearance. Results In 32 patients, Frankel grading was upgraded significantly at post-operative phase and at final follow-up phase compared with pre-operative phase （P 〈0.01）. Cobb angle of the lesioned segment was corrected 18° at post-operative phase compared with pre-operative phase and it showed significant difference （P 〈0.01 ）,while loss 2° at final follow-up phase compared with post-operative phase and it did not show significant diffefence （P 〉0.05）. The fusion rate was 100% observed on dynamic X-ray photo and sagital reconstruction ofCT. ODI score was （12±1.5）% on average and showed significant diffefence（P 〈0.01 ）. There were no apparent pseudarthroses, implant failures and reactivation. Conclusion The operation of posterior lateral debridement and bone grafting and pedical-screw fixation through posterior muscle clearance is proved a safe and effective method for singleinterspace thoraeolumbar tuberculosis.