一期前后路联合手术治疗胸腰椎结核的临床研究

Anterior and posterior combined operation for treatment of thoracic and lumbar tuberculosis

目的探讨一期前后路联合手术治疗胸腰椎结核的临床疗效。方法 65例胸腰椎结核患者,采用一期后路经椎弓根内固定,前路病灶清除植骨融合治疗。所有病例随访12～32个月,平均18个月。结果 65例患者均显示骨性融合,30例合并瘫痪患者中,症状改善28例,术后后凸畸形平均矫正18.3°,无一例结核复发。结论一期前后路联合手术治疗胸腰椎结核可以促进植骨融合和神经功能恢复,矫正后凸畸形,临床效果满意。

Objective To evaluate the clinical of anterior and posterior combined operation for treatment of thoracic and lumbar tuberculosis.Methods Between January 2005 and October 2009,posterior transpedicular screw system internal fixation and anterior radical debridement with interbody fusion procedures were used in 65 patients suffering from thoracic and lumbar tuberculous in our department.All patients were followed up for 12 to 32 monthes.Results All patients showed successful interbody fusion.Among 30 cases of Pott’s paraplegia,28 were recovered in certain degree.The average postoperative correction of kyphosis angle was 18.3degree.All cases were cured.Conclusion Anterior and posterior combined operation for treatment of thoracic and lumbar tuberculosis can enhance the stability of spine in thoracic and lumbar spinal tuberculosis,which is beneficial for successful interbody fusion and recovery of paraplegia,and preventing progression of kyphosis.