病灶清除一期植骨内固定治疗胸腰椎结核

Anterior Debridement and One-stage Bone Fusion with Internal Fixation for Thoracic-lumbar Spinal Tuberculosis

目的探讨病灶清除一期植骨内固定治疗胸腰椎结核的疗效。方法回顾性分析2002年3月～2006年3月期间采用病灶清除一期植骨内固定治疗的胸腰椎结核患者22例的临床资料。结果术后均获随访,平均2.1(0.5～4)年。胸腰背部疼痛消失,X线示术后18个月内获骨性融合者21例(95.5%)。1例术后抗结核治疗仅3月,半年后复发,经再次病灶清除后愈合。术后脊柱后凸角度为10°±4°,平均矫正角度为12.5°。结论前路病灶清除、一期植骨内固定治疗胸腰椎结核是安全有效的,但要严格把握手术的适应证和手术时机。

Objective To discuss the clinical effect of thoracic-lumbar spinal tuberculosis treated by debridement and one-stage bone fusion with internal fixation. Methods The clinical data of 22 patients with thoracic-lumbar spinal tuberculosis admitted from March 2002 to March 2006 was analyzed retrospectively. All cases were treated by anterior debridement and one-stage bone fusion with internal fixation. Results The symptom of lower back pain disappeared in all cases within 0.5 to 4 years （ average 2.1 years） follow-up. 21 cases （95.5%） obtained bone fusion within 18 months postoperatively. One case received antituberculosis therapy only for 3 months and relapsed at 6 months postoperatively, and was cured after reoperation. The average kyphosis angle was 10° ±4°, and average corrective angle was 12.5°. Conclusion Anterior debridement and one-stage bone fusion with internal fixation is safe and effective for thoracic-lumbar tuberculosis with strict indication selection and appropriate operative opportunity.