脊柱结核个体化的手术治疗

Experience of Individualized Surgery of Spine Tuberculosis

目的：探讨脊柱结核不同手术方法的治疗效果。方法：自2004-2010年间收治脊柱结核76例,术前经过严格的化疗后,根据患者发病部位、脊柱破坏的程度、脊柱节段破坏的多少选择个体化的手术治疗。结果：本组病例无一例出现死亡和病情加重现象。手术时间70~150min,平均130min。出血量100~2000ml,平均800ml。在9例截瘫患者中,经手术治疗后分别在术后3~6个月逐渐恢复下肢和大小便功能。本组病例经随访12个月以上无一例出现复发。结论：近年来脊柱结核在临床有增多趋势,其手术入路的选择仍存在很多争议,只要根据患者发病部位、脊柱破坏的程度、脊柱破坏节段的多少、手术熟练的程度和工作经验的积累,实行个体化治疗,才能取得好的治疗效果。

Objective：To observe different surgical methods and clinical efficacy of spine tuberculosis.Method：A total o f 76 cases with spinetuberculosis treated in our hospital between 2004 and 2010 were reviewed. After anti-tuberculosis treatment,all cases accepted different surgeryaccording to the levels and severity of different cases.Result： None of the cases were death or get worse after operation.The operation time was70-150 minutes（average 130 minutes）.The blood loss during the operation was 100-2000 ml（average 800 ml）.The lower limbs and excretoryfunction of the nine paraplegia patients convalesce 3-6 months after surgery.All the cases had a follow-up of no less than 12 months ,no relapse.Conclusion：Due to anatomical site of damage in varying degrees and be complicated by various complications,the spinal tuberculosis should betreated with individualized plan.