分期后前路联合手术治疗老年颈胸段长节段脊柱结核  

Staged surgical treatment of combined posterior and anterior approach for senile multiple cervicothoracic spinal tuberculosis

作　　者：张宏其[1] 胡雄科 尹新华[1] 刘金洋[1] 吴建煌[1] 郭超峰[1] 唐明星[1] 

机构地区：[1]中南大学湘雅医院脊柱外科(湘雅脊柱外科中心),湖南长沙410008

出　　处：《中国骨与关节损伤杂志》2015年第1期14-16,共3页Chinese Journal of Bone and Joint Injury

基　　金：国家自然科学基金面上项目(81271940)

摘　　要：目的探讨分期后路固定前路病灶清除植骨融合治疗老年颈胸段长节段脊柱结核手术的安全性及临床疗效。方法对自2006-12—2011-06诊治的老年颈胸段脊柱结核8例均行分期后前路联合手术,术后继续抗结核治疗12-18个月。结果术后伤口均一期愈合,无结核复发。所有患者获得随访18-64个月,平均39个月。术后3个月内ESR均降至正常。末次随访时神经功能Frankel分级：C级1例,D级2例,E级5例。结论对于老年长节段颈胸段结核采用分期后前路手术具有彻底清除病灶、矫正畸形、360°植骨、重建稳定等优点,是一种安全有效的治疗方法。Objective To investigate the efficacy and outcome of staged surgical treatment for senile multiple cervicothoracic spinal tuberculosis by internal fixation, debridement, fusion and combined interbody via combined posterior and anterior approach. Methods From December 2006 to June 2011, 8 senile patients with cervicothoracic spinal tuberculosis were treated with staged surgical treatment of combined posterior and anterior approach. Anti- tuberculosis treatment continued for12 to 18 months. Results All incisions were healed perfectly without recurrence. All patients were followed up for 18 to 64 months postoperatively（average, 39 months）. The ESR recovered to normal within 3 months postoperatively in all patients. The Franklel score at the last visit showed that 1 case in grade C, 2 cases in grade D and 5 cases in grade E. Bone fusion was achieved within 3-7 months（average, 5.5 months）. Conclusion Staged surgical treatment of combined posterior and anterior approach has the advantages of thorough debridement, correct kyphosis, 360° bone grafting, reconstruction of stability, and it can be an effective treatment method for the treatment of senile multiple cervicothoracic spinal tuberculosis.

关 键 词：脊柱结核 颈胸段 老年人 后路 前路 内固定术 

分 类 号：R529.2[医药卫生—内科学]