【摘要】 目的探讨高龄颈椎结核合并四肢瘫外科治疗的临床疗效与安全性。方法对8例高龄颈椎结核合并四肢瘫患者采用早期前路病灶清除、减压、植骨、内固定手术,并行联合化疗。术前Frankel瘫痪分级:B级2例,C级5例,D级1例。结果术后随访4~36个月,平均8个月,死亡2例:1例术后4个月死于突发肺部感染,1例2年后死于脑血管意外。所有患者术后脊髓功能均有不同程度恢复,Frankel分级D级3例,E级5例。4~6个月X线片显示无骨质破坏复发,植骨处均已骨性融合,无内置物松动、脱落或断裂。结论高龄颈椎结核合并四肢瘫宜在联合化疗的基础上尽早外科干预;在周到、细致的围手术期管理、正确熟练的手术操作技术下,颈前路病灶清除、减压、植骨、内固定治疗高龄颈椎结核并四肢瘫是安全有效的。更多还原

【Abstract】 Objective To study the clinical outcome and security of surgical treatment of senile cervical tuberculosis with quadriplegia.Methods 8 cases of cervical tuberculosis with quadriplegia were treated by anterior cervical discectomy,fusion,internal fixation,and combined with antiotuberculosis medicine treatment.The function of spinal cord were graded by Frankel criteria:2 B,5 C and 1D.Results The follow-up periods ranged from 4 to 36 months,averged 8 months.2 patients died:1 died of acute pneumonia after 4 months,and the other died of cerebrovascular accident after 2 years.The function of spinal cord improved markedly.3 cases were improved to D,5 to E.No recurrence was found.Bony fusions were presented in 4～6 months postoperativly.No fixation failure and recurrent slip were found.Conclusions Combined with antiotuberculosis medicine treatment,surgical treatment should be done in earlier period on senile cervical tuberculosis with quadriplegia;With a thoughtful management surround the operation and a practised technique,anterior cervical discectomy,fusion and internal fixation were safe and effective.更多还原