个体化治疗胸腰椎脊柱结核的体会

目的:探讨胸腰椎脊柱结核的治疗方法和临床疗效。方法:回顾性分析2004年1月～2009年1月间收治的96例胸腰椎脊柱结核的病例,72例合并腰大肌脓肿,37例有神经根或脊髓刺激症状,经抗痨治疗后给予手术治疗,术后抗痨1年。结果:术后患者腰背部疼痛缓解,无神经症状加重,3月后复查神经功能有Frankel一级以上改变者22/37,半年后植骨融合率72/96,无植骨块移位和内固定断裂,术后8例出现术后并发症,经处理后痊愈,复发3例,2例经处理后痊愈,1例放弃治疗。结论:胸腰椎脊柱结核因发病部位、破坏程度不同,且合并症多样,应选择个体化治疗方案。

Experience of Individualized Treatment of Thoracolumbar Spine Tuberculosis

Objective：To observe therapeutic methods and clinical efficacy of thoracolumbar spine tuberculosis （TST）.Methods：A total of 96 cases with TST treated in our hospital between January 2004 and January 2009 were reviewed. Among them, 72 had psoas abscess and 37 had the symptoms of nerve root or spinal cord stimulation. After anti-tuberculosis treatment, all cases accepted surgery and 1 year of anti-tuberculosis treatment after operation. Results：The low back pain was relieved after operation and no neurological symptoms were deteriorated. Three months later, the Frankel Grade which is for evaluation on nerve function increased one more grade in 22 of 37 cases. Six months later, 72/96 cases got a good grafted bone fusion, and no fixation devices fracture occurred; 8/96 cases had postoperative complications and recovered after treatment; tuberculosis recurred in 3/96 cases, of whom 2 recovered after treatment but 1 gave up for further treatment. Conclusion：Due to anatomical site of damage in varying degrees and be complicated by various complications, the thoracolumbar spinal tuberculosis should be treated with individualized plan.