一期改良后路病灶清除植骨内固定治疗胸腰椎结核

One-stage improved posterior debridement and bone grafting with internal fixation for primary surgical management of thoracolumbar spinal tuberculosis

目的:探讨一期改良后路病灶清除植骨内固定治疗胸腰椎结核的安全性及有效性。方法:胸腰椎结核患者18例,采用一期改良后路病灶清除植骨内固定手术治疗。评价手术时间、术中出血量、VAS评分、神经症状缓解情况及手术并发症等。结果:平均手术时间4h,术中平均出血量700ml,手术后2周全部患者疼痛及神经症状均有明显改善,术后无感染、神经损伤等并发症发生,佩戴腰围可下地行走。结论:一期改良后路病灶清除植骨内固定治疗胸腰椎结核疗效满意,并发症少,是一种安全有效的治疗方法。

Objective：To investigate the safety and effectiveness of one-stage improved posterior debridement and interbody autografting for primary surgical management of thoracolumbar spinal tuberculosis. Methods：18 cases of spinal tuberculosis were treated by one-stage improved posterior debridement and bone grafting with internal fixation.The Operation time,intraoperative blood loss,VAS scores,neurological symptoms and complications were evaluated.Results：The average operation time was 4hs,average intraoperative blood loss was 700ml.And the visual pain score （VAS） and neurological symptoms were significantly improved 2 weeks after surgeries.All patients can go on feet with brace without the occurrence of such complications as postoperative infections and nerve lessions.Conclusion：One-stage posterior debridement and interbody autografting with internal fixation provides a satisfactory outcomes and with fewer complications for the treatment of thoracolumbar spinal tuberculosis.