后路椎弓根螺钉内固定结合前路病灶清除植骨术治疗腰骶椎体结核35例

Posterior pedicle screw fixation combined with anterior debridement in the treatment of 35 cases of lumbar vertebral tuberculosis

目的：探讨后路椎弓根螺钉内固定结合前路病灶清除植骨术治疗腰骶椎结核的效果。方法：收治脊柱结核患者35例，采用Ⅰ期后路椎弓根螺钉内固定结合前路病灶清除自体髂骨植骨术治疗。结果：全部患者结核病灶治愈，均达到植骨融合，无复发，术后Cobb角平均3.2b，腰背疼痛症状明显改善，VAS评分2.5分，神经功能改善情况良好。结论：椎弓根钉棒内固定结合前路病灶清除植骨术治疗L4～S1椎体结核可彻底清除病灶，矫正后凸畸形，早期重建和维护脊柱的稳定性，是安全、有效的治疗方法。

Objective:To discuss the effect of posterior pedicle screw fixation combined with anterior debridement in the treatment of lumbar vertebral tuberculosis.Methods:35 patients with spinal tuberculosis were selected,in the phase I treatment of anterior debridement with posterior pedicle screw internal fixation combined with anterior debridement and bone graft.Results:All the patients were cured, and the fusion of bone graft was achieved without recurrence,Cobb angle averaged 3.2 b,the symptoms of low back pain were significantly improved,the VAS score was 2.5 points and the neurological function improved.Conclusion:Pedicle screw fixation combined with anterior debridement and bone graft for treatment of spinal tuberculosis with L4～S1 can completely remove the lesion,correct the deformity,early reconstruction and maintenance of spinal stability,is a safe and effective treatment method.