一期前后路手术治疗胸腰椎结核的临床研究

Clinical study of one-stage combined anterior and posterior approaches in the treatment of thoracolumbar tuberculosis

目的观察一期前后路手术治疗胸腰椎结核的临床效果。方法回顾性分析我院2004年1月～2007年12月经一期前后路手术治疗的15例胸腰椎结核病例临床资料。结果所有病例随访6～36个月,平均13个月。除2例残留供骨区疼痛的症状外,其他病例无并发症发生,亦无复发,均达到骨性融合。愈合时间3～8个月,无内固定松动及断裂发生。手术前平均Cobb氏角平均33.4°,术后随访Cobb氏角平均为17.1°。结论对胸腰椎结核患者行一期前后路手术治疗可有效矫正脊柱畸形,重建脊柱的稳定,获得良好的融合,彻底根治病灶,无特殊并发症,效果良好肯定。

Objective To evaluate the clinical effectiveness of the one-stage combined anterior and posterior operation for treatment of thoracolumbar spinal tuberculosis. Methods The clinical data of 15 cases of thoracolumbar spinal tuberculosis from Jan. 2004 to Dec. 2007 were analyzed retrospectively. Results All patients were followed up for 6-36 months with an average of 13 months. All of the results showed successful interbody fusion in 3-8 months. There were no recurrence and complications except pain in the region where iliac crest harvested from 2 cases. There were no breakage and loosening of pedicle screw. The preoperative and postoperative Cobb＇s angles were averageiy 33. 4° and 17. 1° respectively. Conclusion The satisfactory results show that anterior radical debridement, interbody fusion and posterior transpedicular screw system internal fixation in the treatment of thoracolumbar spinal tuberculosis are helpful for correction of the kyphotic deformity and restoration of the stability of spine.