关键词: 结核, 脊柱, 胸椎, 外科手术, 选择性, 椎体成形术, 治疗结果

Abstract:

Objective To analyzed the clinical efficacy of one-stage anterior debridement with titanium cage bone graft and system internal fixation with screw rod in the treatment of thoracic spinal tuberculosis.Methods Twenty eight patients with thoracic spinal tuberculosis who were underwent surgery of one-stage anterior debridement with titanium cage bone graft and system internal fixation with screw rod in our hospital during Sep. 2009 to Dec. 2016. Twenty one patients were followed up including male in 14 cases and female in 7 cases. There was one patient with the fifth and sixth thoracic spinal involved, three patients with the sixth and seventh thoracic spinal involved, three patients with the seventh and eighth thoracic spinal involved, two patients with the ninth and tenth thoracic spinal involved, four patients with the tenth and eleventh thoracic spinal involved, two patients with the eleventh and twelfth thoracic spinal involved, one patient with the sixth, seventh and eighth thoracic spinal involved, three patients with the seventh, eighth and ninth thoracic spinal involved, and two patients with the ninth, tenth and eleventh thoracic spinal involved. According to the results of preoperative and postoperative follow-up of Frankel spinal cord injury grade, visual analogue score (VAS), Cobb angle correction of kyphosis and bone graft fusion, the clinical efficay was assessed.Results There were grade B in one case, grade C in five cases, grade D in six cases, grade E in nine cases according to preoperative Frankel grade assessment, and grade D in four cases, grade E in seventeen cases according to Frankel grade assessment in the last follow-up ranged from 10 months to seven years. The VAS was average 6.29±1.27 scores before operation, average 2.81±0.87 scores at one week after operation and average 1.24±0.89 scores at the last follow-up. The Cobb angle was average 19.81±11.08 degrees before operation, average 3.81±2.77 degrees at one week after operation and average 4.52±3.23 degrees at the last follow-up. Bone fusion was achieved in all 21 patients. The fusion time was 6.93±1.33 months ranged from 5 to 11 months. No case was found loosening, shedding and fracture of the internal fixation system at the last follow-up.Conclusion One-stage anterior debridement with titanium cage bone graft and system internal fixation with screw rod can achieve good clinical effect including effective debridement, nerve compression relieved, kyphosis correction and spinal stability reconstruction in the treatment of thoracic spinal tuberculosis.

Key words: Tuberculosis, spinal, Thoracic vertebrae, Surgical procedures, selective, Vertebroplasty, Treatment outcome