一期前后路联合手术治疗胸腰椎结核

One stage anterior and posterior fusion and posterior fixation for the treatment of thoracic and lumbar spinal tuberculosis

目的:探讨胸腰椎结核一期前后方融合、后路内固定治疗的临床疗效。方法:28例胸腰椎结核患者采用一期前路或侧前方入路病灶清除、植骨,后路椎弓根螺钉固定。结果:平均手术时间为190min,出血量为800～1500ml,植骨融合时间为3～16个月。术后均无神经症状加重,术后切口一期愈合,术后12～18个月停用抗结核药物无复发。结论:采用一期前后方融合后路内固定治疗胸腰椎结核,能有效地清除病灶,重建脊柱稳定性,促进植骨融合并能为截瘫恢复创造良好条件。

Objective：To evaluate the clinical effect of one stage anterior and posterior fusion and posterior fixation for the treatment of thoracic and lumbar spinal tuberculosis.Methods：A total of 28 patients with thoracolumbar tuberculosis were treated with anterior focus clearance and bone graft and posterior approach pedicle internal fixation.Results：The average operation time was 190 min,blood loss was 800-1 500 ml.After operation,spinal fusion was achieved in all the cases within 3-16 months on average.All patients,no progress of neurological,no formation of sinus tractor fistulae.12-18 months postoperative antituberculotic was taken out of service,and no recurrence.Conclusion：One stage anterior and posterior fusion and posterior fixation can effectually resect focus,rebuild stability of spine,promote interbody fusion and recovery of incomplete paraplegia in treating thoracic and lumbar spinal tuberculosis.