Mukhtar Ahmed M, Farghaly Medhat M, Ahmed Shaban H
Al Razi Orthopedic Hospital, Al-Adan Hospital, Kuwait.
Med Princ Pract. 2003 Apr-Jun;12(2):92-6. doi: 10.1159/000069113.
To evaluate the efficacy and clinical outcome of simultaneous or sequential anterior and posterior surgical approaches in the management of spinal tuberculosis in the form of anterior extirpation of the tuberculous lesion, strut bone grafting of the defect produced and posterior instrumentation for spinal fixation.
Twenty-two patients who had tuberculosis of the thoracic and lumbar spine with moderate to severe localized kyphosis and variable degrees of neurological deficits were treated at Al Razi Hospital (Kuwait) in the period from 1998 to 2000 by anterior debridement and autogenous strut bone grafting with simultaneous or staged posterior spinal fixation using either USS or SOCON spinal instrumentation. Appropriate antituberculosis treatment was given to all patients for 9-12 months. The postoperative follow-up period was 18 months.
Of the 22 cases the average of preoperative kyphosis was 42 degrees. The average of immediate postoperative correction was 27 degrees. At the last follow-up the average correction was 24 degrees and the loss of correction did not exceed 3 degrees. Average fusion times were 5 months for one-segment fusions and 8 months for two-segment fusions. There was no recurrence of the disease in any of the cases.
Posterior instrumental stabilization and anterior interbody fusion were found to be effective in arresting the disease, correcting kyphotic deformity and maintaining correction until solid spinal fusion.
评估同期或分期前后路手术治疗脊柱结核的疗效及临床结果，手术方式包括前路结核病灶清除、缺损处支撑植骨以及后路脊柱内固定。
1998年至2000年期间，科威特拉齐医院对22例患有胸腰椎结核且伴有中度至重度局部后凸畸形及不同程度神经功能缺损的患者进行了治疗，采用前路清创及自体支撑植骨，并同期或分期使用USS或SOCON脊柱内固定器械进行后路脊柱固定。所有患者均接受了9至12个月的抗结核治疗。术后随访期为18个月。
22例患者术前平均后凸角度为42度。术后即刻平均矫正角度为27度。末次随访时平均矫正角度为24度，矫正丢失不超过3度。单节段融合平均时间为5个月，双节段融合平均时间为8个月。所有病例均无疾病复发。
后路器械稳定及前路椎间融合被证明在控制疾病、矫正后凸畸形以及维持矫正直至脊柱牢固融合方面是有效的。
