后路椎弓根系统内固定加前路植骨融合治疗胸腰椎结核

Posterior transpedicular screw system internal fixation and anterior interbody fusion in the tuberculosis of thoracic and lumbar spine

目的 :探讨应用后路椎弓根系统内固定加前路植骨融合术治疗胸腰椎结核的临床效果。方法 :回顾总结1 995年 3月至 2 0 0 0年 3月行后路椎弓根系统内固定同期前路植骨融合的胸腰椎结核患者 35例 ,包括植骨融合率、截瘫恢复情况和后凸畸形矫正状况。随访时间 1 5～ 5年 ,平均 3 4年。结果 :术后 1～ 1 5年所有患者均显示骨性融合 ;2 8例合并截瘫患者中 ,症状改善 2 6例 ,改善率 92 9% ;术后后凸畸形平均矫正 2 9 7° ,1 5～ 5年后随访 ,后凸角度平均丢失 2 9°。结论 :后路椎弓根系统内固定加前路植骨融合能加强脊柱的稳定性 ,促进骨融合和截瘫恢复 。

Objective:To evaluate the clinical effectiveness of posterior transpedicular screw system internal fixation and anterior interbody fusion procedure for treating thoracic and lumber spinal tuberculosis.Method:From March 1995 to March 2000,posterior transpedicular screw system internal fixation and anterior interbody fusion procedures were used in 66 patients suffering from thoracic and lumber spinal tuberculosis in our department,35 of them were involved in a longitudinal study with follow up for a mean of 3 4(1 5～5)years postoperatively.Result:All patients showed successful interbody fusion.Among 28 cases of Pott′s paraplegia,22 were completely recovered,4 were partly recovered,the rate of recovery was 92 9%.The average immediate postoperative correction of kyphosis angle was 29 7 degree,the average loss of correction was only 2 9 degree at final follow up.Conclusion:Posterior transpedicular screw system internal fixation and anterior interbody fusion procedure are found helpful in strengthening the stability of the spine in thoracic and lumber spinal tuberculosis,providing successful interbody fusion and recovery of Pott′s paraplegia,correcting the kyphosis,and preventing progression of kyphosis.