【摘要】 目的探讨一期单纯经后路手术治疗胸腰椎结核的效果。方法选取我院2008年3月~2013年10月收治住院的63例胸腰段结核患者为研究对象。入选病例均采用一期单纯经后路病灶清除、椎体间植骨融合、钉棒内固定治疗,术前、术后予规范的抗结核治疗。根据患者的疼痛视觉模拟评分(VAS)、Cobb角矫正、神经功能恢复及结核转归、植骨融合等情况评价临床疗效。结果所有患者均顺利完成手术,手术时间为(210.0±45.8)min,术中出血量为(550±139)ml。63例患者均获随访,时间为(31.0±12.1)个月,植骨融合时间为(5.0±1.3)个月。所有患者未出现切口感染、慢性窦道形成、感染性脑脊髓膜炎等并发症,末次随访时未见结核复发。21例术前有神经功能障碍的患者神经功能改善1~2个等级;VAS评分由术前(7.8±0.7)分降至术后(1.9±0.3)分(F=21.4,P<0.05);Cobb角由术前(27.6±5.3)°矫正为末次随访时(9.8±4.3)°(F=83.6,P<0.05),终末矫正率为63.5%。结论采用一期单纯经后路病灶清除、椎体间植骨融合、椎弓根钉内固定术式治疗短节段且病灶较局限的胸腰椎结核可取得良好的效果。更多还原

【Abstract】 Objective To explore the clinical effects of one stage simple posterior approach in the treatment of thoracic and lumbar spine tuberculosis.Methods 63 patients with thoracic and lumbar spine tuberculosis in our hospital from March 2008 to October 2013 were selected as study object.All patients were used one stage simple posterior debridement,interbody fusion and screw rod internal fixation,anti tuberculosis treatment before operation and after operation were used.The clinical effects were evaluated according to pain visual analogue scale(VAS),Cobb angle correction,recovery of neurological function,prognosis of tuberculosis and bone graft fusion.Results All patients were successfully completed surgery,and the operation time and bleeding during operation was respectively(210.0±45.8)min and(550±139) ml.63 patients were followed up,and the following up time and bone graft fusion time was respectively(31.0 ±12.1) months and(5.0±1.3) months.No patients appeared complications of incision infection,chronic sinus formation and infectious meningitis.No recurrence of tuberculosis was seen at the last follow-up.The neurological function of 21 patients with neurological dysfunction improved 1 to 2 grades;VAS score reduced from(7.8±0.7) scores before operation to(1.9±0.3) scores after operation(F=21.4,P<0.05);Cobb angle was corrected from(27.6 ±5.3)° before operation to(9.8 ±4.3)° at the last follow-up(F=83.6,P<0.05) and the last correct rate was 63.5%.Conclusion Using one stage simple posterior debridement,interbody fusion and screw rod internal fixation in treating short segment and circumscribed lesions of thoracic and lumbar tuberculosis can get good treatment effects.更多还原