一期病灶清除植骨融合内固定术治疗胸腰椎结核

目的观察一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9月期间,43例采用一期病灶清除植骨融合内固定术治疗的胸腰椎结核病患者并随访,观察患者症状及截瘫改善情况、后凸畸形矫正情况及植骨融合情况。结果所有患者均获得随访,平均随访3.6+1.5年;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l～3级;植骨均在术后6个月～2年融合,治愈率58.08%,好转率18.58%。后凸Cobb角平均矫正25.7°。结论一期病灶清除植骨融合内固定术可有效地治疗胸腰椎结核,并能够同时矫正胸腰椎后凸畸形,患者可早期下床活动,临床疗效满意。

The one-stage operation of debridement and fusion with internal fixation for the treatment of thoracolumbar spinal tuberculosis

Objective To evaluate the clinical result about debridement and fusion with internal fixation to treat of thoracolumbar spinal tuberculosis.Method 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 alongitudinal study with a mean follow-up of 3.6（1.5-6）years.Result All patients showed evidence of successful autograft fusion in 6 months to no more than 2 years.Among 8 cases with Pott＇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 fixationand debridement and bone fusion the of the in thoracolumbar spinal tuberculosis,which canprovide successful interbody fusion and guarrentee excellent clinical outcome.