一期后路经椎弓根内固定、前路病灶清除、植骨融合治疗胸腰椎结核

One-stage surgical management for tuberculous spondylitis of thoracic and lumbar by anterior decompression,grafting,fusion,and posterior transpedicular instrumentation

目的探讨一期后路经椎弓根内固定、前路病灶清除、植骨融合治疗胸腰椎结核的安全性及疗效。方法2004年12月～2007年10月该院收治胸腰椎结核患者78例,采用一期后路经椎弓根内固定、前路病灶清除、植骨融合治疗。结果所有病例随访1年以上,78例患者脊柱结核均治愈,无局部结核复发,植骨全部骨性融合,融合时间平均为4.6个月。术后后凸矫正角度平均22.9°,1年随访后平均丢失3.6°。结论一期后路经椎弓根内固定、前路病灶清除、植骨融合治疗胸腰椎结核是安全和有效的。

[Objectives] To explore the safety and the curative effect of one-stage surgical management for tubereulous spondylitis of thoracic and lumbar by anterior decompression, grafting, fusion, and posterior transpedieular instrumentation. [Methods] 78 patients with tuberculous spondylitis of thoracic and lumbar were selected from Xi- angya Hospital between 2004 and 2007. All patients underwent one-stage surgical management by anterior decompression, grafting, fusion, and posterior instrumentation. [Results] 78 patients were all followed up for more than one year. They were cured with no local recurrence. The bone graft gained bone fusion during 4.6 months in average. The angle of kyphosis which was corrected was 22.9° after operation. The loss of which was 5.6° after one year. [Conclusions] The one-stage surgical management for tuberculous spondylitis of thoracic and lumbar by anterior decompression, grafting, fusion, and posterior instrumentation is safe and effective.