手术治疗胸腰椎结核的初步报告

目的评价手术治疗胸腰椎结核的疗效。方法2002年1月～2009年1月我院收治35例脊柱胸腰椎结核患者，病变均累计2个或2个以上椎体，合并椎旁脓肿32例。患者术前脊髓神经功能损伤20例，Frankel分级：B级4例，c级10例，D级6例。结果平均手术时间（1．5±0．6）h，平均出血量（400±120）ml。术中3例发生胸膜撕裂，行术中缝合，放置引流，术后无并发症发生；3例手术侧大腿前内侧放射痛麻木，经治疗后逐渐消失，2例术后1月余出现复发，伤口不愈合，经再手术后治愈，无大血管、神经损伤，无死亡病例。术后随访3月～5年（平均17．1月），骨融合时间平均6．4月，术后神经功能均恢复至E级，12月后血沉均恢复至正常，末次随访无1例出现明显矫正度丢失。结论手术治疗脊柱胸腰椎结核疗效确切。

Effect of the treatment of thoracic and lumbar spinal tuberculosis by surgery

Objective To explore the curative effect of the treatment of thoracic and lumbar spinal tuberculosis by surgery. Methods From January 2002 to January 2009, 35 patients were treated by surgery with thoracic and lumbar spinal tuberculosis. The segments of thoracic and lumbar vertebrae were invalved with two or no less than two, 19 cases had paravertebral abscess. Twenty cases had neurolgical dificits （4 cases in Frankel B, 10 cases in Frankel C, 6 cases in Frankel B）. Results The averge operative time was （ 1.5 ±0. 6 ） h, and the avergae blood loss was （400 ±120） ml. 3 case had pleural membrane laceration, it was sutured during operation and no complicaton occurred after operation. 3 patients felt pain and numbness in the left limb, which were relieved with treatment. 2 case was palindromia sign of paravertebral abscess, and the incisions hadn＇ t healed, It healed with another operation. There aere no injuries of large blood vessels and nerves, no death case occurred. All the cases were followed - up from three months to five years （ average 17.1 months ）, the bony fusion occurred in 6.4 months, the nurological fuction of all cases had recovered to Frankel E and ESR became normal after 1 or 2 months. Conclusion The treatment of thoracic and lumbar spinal tuberculosis by surgery is a safe and effetive mothod.