Zhou Tianhua, Li Chuan, Liu Bin, Tang Xun, Su Yongyue, Xu Yongqing
Department of Orthopedics, Kumming General Hospital of Chengdu Military Command, No.212 Daguan Road, Kunming, 650032, Yunnan, China.
J Orthop Surg Res. 2015 May 13;10:64. doi: 10.1186/s13018-015-0195-7.
This study aims to explore the efficacy and safety of posterior vertebral column resection (PVCR) in treating thoracolumbar spinal tuberculous angular kyphosis (TSTAK).
From January 2008 to January 2012, 17 TSTAK patients were treated surgically, including five males and 12 females, with an average age of 23.6 years, among five cases who had the kyphotic apical vertebrae located at the thoracic vertebrae, ten cases were located at the thoracolumbar segment, and two cases were located at the lumbar vertebrae. The kyphotic Cobb angle was measured in the preoperative, postoperative, and final follow-up, respectively, and the nerve function ASIA classification was assessed.
The mean operative time was 364 min; the average intraoperative blood loss was 2,218 ml; and the average intraoperative blood transfusion was 1,863 ml. Among the five patients with the preoperative nerve function as grade D, four of them recovered to grade E. The preoperative average Cobb angle was 81.3° ± 12.8°, while the postoperative average Cobb average was 17.3° ± 3.6°; while it was significantly improved than the preoperative (P < 0.01), the average kyphosis correction rate was 68.7% ± 6.5%; the postoperative average follow-up was 18.7 months, with an average correction loss as 3.3°.
PVCR could be safely and effectively used in TSTAK.
本研究旨在探讨后路脊柱全椎体切除术(PVCR)治疗胸腰椎脊柱结核角状后凸畸形(TSTAK)的疗效及安全性。
2008年1月至2012年1月,对17例TSTAK患者实施手术治疗,其中男性5例,女性12例,平均年龄23.6岁。5例后凸顶椎位于胸椎,10例位于胸腰段,2例位于腰椎。分别于术前、术后及末次随访时测量后凸Cobb角,并评估神经功能ASIA分级。
平均手术时间为364分钟;平均术中出血量为2218毫升;平均术中输血量为1863毫升。术前神经功能为D级的5例患者中,4例恢复至E级。术前平均Cobb角为81.3°±12.8°,术后平均Cobb角为17.3°±3.6°;与术前相比有显著改善(P<0.01),平均后凸矫正率为68.7%±6.5%;术后平均随访18.7个月,平均矫正丢失为3.3°。
PVCR可安全有效地应用于TSTAK。