Ⅰ期病灶清除植骨内固定术治疗胸腰椎结核临床疗效分析

Clinical Observation about Debridement and Fusion with Internal Fixation to Treat Thoraco-Lumber Spinal Tuberculosis

目的观察Ⅰ期病灶清除植骨融合内固定术治疗胸腰椎结核病的临床疗效。方法回顾性分析2000年2月～2011年4月期间郑州市二七区马寨镇卫生院采用Ⅰ期病灶清除植骨融合内固定术治疗胸腰椎结核病的19例患者,分析其症状及截瘫改善、后凸畸形矫正与植骨融合状况。结果所有患者均跟踪随访3.0±1.5 a;所有患者症状均显著改善,5例合并截瘫患者中,3例完全康复,2例ASIA分级改善1～3级;植骨均在手术后0.6～2 a融合。治愈率63.18%,好转率21.76%,后凸Cobb角平均矫正28.34°。结论Ⅰ期病灶清除植骨融合内固定术可有效治疗胸腰椎结核患者,并能矫正后凸畸形,临床效果满意。

Objective To evaluate clinical result about debridement and fusion with internal fixation to treat thoraco-lumbar spinal tuberculosis.Methods 19 cases suffered from thoraco-lumbar spinal tuberculosis between Feb.2000 and Apr.2011 were managed by one-stage transpedicular screw system internal fixation and anterior debridement and autograft fusion were reviewed retrospectively.All cases were involved in a longitudinal study with a following-up of 3.6（1.5-5.5） years.Results All patients showed evidence of successful autograft fusion in 6 months to no more than 2 years.Among 8cases of Pott＇S paraplegia,5 recovered completely,3 recovered partly with 1-3 grades of improvement according to ASIA score system.The total ratio of recovery was 58.08%.The average immediate postoperative correction angle was 25.7°.Conclusion One-stage transpedicular screw fixation and debridement and bone fusion of thoraco-lumbar spinal tuberculosis can provide successfully interbody fusion and guarantee excellent clinical outcome.It is safe and better.