Suh Kuen Tak, Seong Yoon Jae, Lee Jung Sub
Department of Orthopedic Surgery, Pusan National University School of Medicine, Busan, Korea.
Asian Spine J. 2008 Dec;2(2):94-101. doi: 10.4184/asj.2008.2.2.94. Epub 2008 Dec 31.
This is a retrospective study.
We wanted to evaluate the treatment outcomes of performing simultaneous anterior and posterior surgery for patients with tuberculous spondylitis and psoas abscess.
Although various treatment options have been used for spinal tuberculosis, there are only a few reports on the treatment of tuberculous spondylitis with psoas abscess.
Between March 1997 and February 2006, we performed operations on 14 cases of tuberculous spondylitis with psoas abscess. All the cases underwent anterior debridement with an interbody bone graft and posterior fusion with using pedicle screws.
Under the Frankel classification, 1 case improved by two grades, 10 cases improved by 1 grade and 3 cases demonstrated no change. The Kirkaldy-Willis functional outcomes were classified as excellent in 10 cases and good in 4. One year after surgery, bony union was confirmed in all 14 cases. The mean kyphotic angle of the spinal lesion was 12.4 degrees and the mean lordotic angle at the final follow-up was 6.4 degrees . Postoperative complications (superficial wound infections) were encountered in 2 cases.
Our results demonstrate that anterior debridement with interbody bone grafting and posterior instrumented fusion can provide satisfactory results for treating tuberculous spondylitis with psoas abscess in patients with neurological deficits.
这是一项回顾性研究。
我们想要评估对患有结核性脊柱炎和腰大肌脓肿的患者同时进行前路和后路手术的治疗效果。
尽管已经采用了各种治疗方法来治疗脊柱结核，但关于伴有腰大肌脓肿的结核性脊柱炎的治疗报告却很少。
在1997年3月至2006年2月期间，我们对14例伴有腰大肌脓肿的结核性脊柱炎患者进行了手术。所有病例均接受了前路清创、椎间植骨以及使用椎弓根螺钉进行后路融合术。
根据Frankel分级，1例改善了两级，10例改善了一级，3例无变化。Kirkaldy-Willis功能结果分类为：10例优秀，4例良好。术后1年，14例均证实有骨融合。脊柱病变的平均后凸角为12.4度，末次随访时的平均前凸角为6.4度。2例出现术后并发症（浅表伤口感染）。
我们的结果表明，前路清创椎间植骨和后路器械融合术可为治疗伴有神经功能缺损的结核性脊柱炎合并腰大肌脓肿患者提供满意的效果。
