胸腰椎结核一期手术治疗的临床观察

Clinical observation of one-stage surgical management for thoracic and lumbar spinal tuberculosis

目的探讨一期手术在胸腰椎结核外科治疗中的临床疗效。方法自2004年2月-2007年5月，一期手术治疗胸腰椎结核22例，其中胸椎9例，行前路径胸病灶清除、植骨融合，内固定。腰椎结核13例，先行后路椎弓螺钉固定，在经前路行病灶清除、植骨融合。结果19例得到随访，随访时间3-24个月，18例植骨融合良好，红细胞沉降率正常，无复发。1例术后3个月复发。结论一期手术治疗胸腰椎结核，可以缩短病程，提高疗效，减轻患者的痛苦，节省费用。

Objective To evaluate the clinical efficacy of one-stage surgical management for thoracic and lumbar spinal tuberculosis. Methods Twenty-two cases of thoracic and lumbar spinal tuberculosis were treated surgically by one-stage proce- dure from February 2004 to May 2007, including anterior resection interbody autografting and anterior instrumentatrion in 9 cases and posterior instrumentation and anterior resection plus interbody autografting in 13 cases. Results Nineteen patients were followed up for 3 to 24 months. In 18 cases, spinal fusion was satisfactory, erythrocyte sedimentation rate was normal and no recurrence was found. Recurrence occurred in one case one month after operation. Conclusion One-stage surgical man- agement for thoracic and lumbar spinal tuberculosis can shorten course of diseases, enhance curative effectiveness, alleviate suf7 feting, and economize expenses.