一期单纯经后路手术治疗胸腰椎结核的临床效果分析.docVIP

一期单纯经后路手术治疗胸腰椎结核的临床效果分析 　　[摘要]目的 探?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 　　[关键词]脊柱结核；后入路手术；病灶清除；植骨融合；内固定 　　[中图分类号] R529.2 [文献标识码] A [文章编号] 1674-4721（2016）11（a）-0063-05 　　Clinical effects analysis of one stage simple posterior approach in the treatment of thoracic and lumbar spine tuberculosis 　　LIU Han-hui LI Hui LIU Hu 　　Spinal Surgery，Nanhai District People′s Hospital of Foshan City in Guangdong Province，Foshan 528200，China 　　[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