Louw J A
Kalafong Hospital, Pretoria, Republic of South Africa.
J Bone Joint Surg Br. 1990 Jul;72(4):686-93. doi: 10.1302/0301-620X.72B4.2380228.
Nineteen patients with thoracic or thoracolumbar spinal tuberculosis and neurological deficits were treated by anterior debridement, decompression and vascularised rib grafting, followed, either during the same procedure or 14 days later, by multilevel posterior osteotomies, instrumentation and fusion. Surgery was performed under cover of four-drug antituberculosis chemotherapy, given for 12 months. The average pre-operative kyphotic angulation of 56 degrees was reduced to 27 degrees postoperatively and 30 degrees at the latest follow-up (3 degrees loss of correction). Radiological fusion between the vascularised rib graft and the vertebrae was seen after an average of 3.3 months. Eighteen patients (95%) had normal neurological function at 14 months, and the other could walk with the aid of crutches.
19例患有胸椎或胸腰椎脊柱结核并伴有神经功能缺损的患者接受了前路清创、减压和带血管蒂肋骨移植治疗，随后在同一手术过程中或14天后进行了多节段后路截骨、内固定和融合手术。手术在四联抗结核化疗的掩护下进行，化疗持续12个月。术前平均后凸角为56度，术后降至27度，最近一次随访时为30度（矫正丢失3度）。平均3.3个月后可见带血管蒂肋骨移植与椎体之间出现放射学融合。18例患者（95%）在术后14个月时神经功能正常，另一例患者借助拐杖行走。
