胸椎结核椎管内外病灶清除同期后路内固定矫形

Focal debridement and posterior transpedicular instrumentation in management of the thoracic tuberculosis at same stage

目的:探讨胸椎结核Ⅰ期病灶清除及后路短节段椎弓根螺钉系统重建脊柱稳定性的外科治疗方法。方法:对1999年2月以来收治的15例合并椎管内外脓肿的胸椎结核患者,采用后路Ⅰ期双侧肋骨横突切除病灶清除、短节段椎弓根螺钉矫正脊柱后凸畸形、取髂骨植骨的综合性手术方法进行治疗,并对其疗效进行分析。结果:术后随访6个月-2年5个月,平均1年8个月,本组15例术后胸部症状均完全消失,术后脊柱后凸角度为6°-15°,平均矫正度数为17°。术后脊髓神经功能均有不同程度的改善,植骨全部骨性融合,植骨融合时间平均3.2个月。结论:经后路可Ⅰ期有效地进行胸椎结核的彻底病灶清除及脊柱稳定性的重建。

Objective:To explore the unified management of the thoracic tuberculosis by focal debridement and posterior transpedicular instrumentation at same stage. Methods:Fifteen patients of the thoracic tuberculosis with internal and external spinal canal abscess were treated with primary focal debridement and posterior transpedicular instrumentation from February 1999,effects of the all patients were analyzed after operation. Results: All the patients healed without recurrence after follow-up for an average of 20 months. Neurologic deficits were much improved,kyphotic deformity improved in all patients with the average correction angle of 17°, spinal fusion occurred in 3.2 months on average after operation. Conclusion: Focal debridement and posterior transpedicular instrumentation are the effective methods for the treatment of the thoracic tuberculosis at same stage.