Department of Spinal Surgery, General Hospital of Ningxia Medical University, 804 Shengli Street, Yinchuan 750004, Ningxia Hui Autonomous Region, China.
Arch Orthop Trauma Surg. 2012 Oct;132(10):1429-35. doi: 10.1007/s00402-012-1575-7. Epub 2012 Jun 27.
The routine surgical approach to posterior reconstruction in spinal tuberculosis is short- or long-segment fixation and/or fusion. This method sacrifices movement at more than one vertebral level, limits normal movement of the spinal column, and leads to degeneration of the small joints of the adjacent levels. Surgical techniques that reduce the number of fixed vertebral levels and maximize the retention of movement of the spinal column are of current interest in the treatment of spinal tuberculosis.
A total of 106 patients with lumbosacral tuberculosis were randomly divided into two groups: a single-segment fixation group and a short-segment fixation group. After posterior correction and internal fixation, all patients underwent anterior radical debridement and interbody fusion with bone grafting.
The mean postoperative follow-up period was 58.09 ± 17.01 months. The average bone graft healing time was 4.35 ± 1.04 months in the single-segment group and 4.47 ± 1.10 months in the short-segment group. In the single-segment group, correction of the Cobb angle was 14.47 ± 3.76° and the loss rate was 7.22 %, and in the short-segment group, correction of the Cobb angle was 16.20 ± 2.70° and the loss rate was 6.37 % (P < 0.05). Patients with operative time, blood loss, costs in the single-segment group were significantly reduced than the short-segment group (P < 0.05).
Single-segment pedicle screw fixation and correction surgery can fix and fuse the diseased segment in lumbar and sacral tuberculosis, retain normal movement in the adjacent spinal column, and promote functional recovery of the spinal column postoperatively. It was be regarded as a cost-effective means of treatment with lumbar and sacral tuberculosis.
脊柱结核后路重建的常规手术方法是短节段或长节段固定和/或融合。这种方法会牺牲一个以上节段的活动度，限制脊柱的正常活动，导致相邻节段小关节退化。在脊柱结核的治疗中，减少固定节段数量并最大限度保留脊柱活动度的手术技术是目前的研究热点。
将 106 例腰骶段结核患者随机分为两组：单节段固定组和短节段固定组。后路矫正内固定后，所有患者均行前路根治性清创和植骨椎间融合术。
平均术后随访 58.09 ± 17.01 个月。单节段组骨愈合时间平均为 4.35 ± 1.04 个月，短节段组为 4.47 ± 1.10 个月。单节段组 Cobb 角矫正为 14.47 ± 3.76°，丢失率为 7.22%，短节段组 Cobb 角矫正为 16.20 ± 2.70°，丢失率为 6.37%（P<0.05）。单节段组手术时间、出血量、费用均明显低于短节段组（P<0.05）。
单节段椎弓根螺钉固定矫正术可固定和融合腰骶段结核病变节段，保留相邻脊柱的正常活动度，促进术后脊柱功能恢复，是一种具有成本效益的腰骶段结核治疗方法。
