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一期后路经椎间孔腰椎椎间融合术、清创术、有限减压术、三柱重建术及后路内固定术治疗单节段腰椎结核

Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation in surgical treatment for single-segment lumbar spinal tuberculosis.

作者信息

Zeng Hao, Wang Xiyang, Zhang Penghui, Peng Wei, Liu Zheng, Zhang Yupeng

机构信息

Xiangya Hospital of Central South University, Department of Spine Surgery, Changsha, People's Republic of China.

出版信息

Acta Orthop Traumatol Turc. 2015;49(5):513-21. doi: 10.3944/AOTT.2015.14.0037.

Abstract

OBJECTIVE

The aim of this study is to determine the feasibility and efficacy of surgical management of single-segment lumbar spinal tuberculosis (TB) by using single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation.

METHODS

Seventeen cases of single-segment lumbar TB were treated with single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation. The mean follow-up was 36.9 months (range: 24-62 months). The kyphotic angle ranged from 15.2-35.1° preoperatively, with an average measurement of 27.8°. The American Spinal Injury Association (ASIA) score system was used to evaluate the neurological deficits and erythrocyte sedimentation rate (ESR) used to judge the activity of TB.

RESULTS

Spinal TB was completely cured in all 17 patients. There was no recurrent TB infection. The postoperative kyphotic angle was 6.6-10.2°, 8.1° in average, and there was no significant loss of the correction at final follow-up. Solid fusion was achieved in all cases. Neurological condition in all patients was improved after surgery.

CONCLUSION

Single-stage posterior transforaminal lumbar interbody fusion, debridement, limited decompression, 3-column reconstruction, and posterior instrumentation can be a feasible and effective method the in treatment of single-segment lumbar spinal TB.

摘要

目的

本研究旨在确定采用一期后路经椎间孔腰椎椎间融合术、病灶清除、有限减压、三柱重建及后路内固定治疗单节段腰椎结核(TB)的可行性和疗效。

方法

17例单节段腰椎结核患者接受了一期后路经椎间孔腰椎椎间融合术、病灶清除、有限减压、三柱重建及后路内固定治疗。平均随访36.9个月(范围:24 - 62个月)。术前后凸角范围为15.2 - 35.1°,平均测量值为27.8°。采用美国脊髓损伤协会(ASIA)评分系统评估神经功能缺损情况,红细胞沉降率(ESR)用于判断结核的活动情况。

结果

17例患者的脊柱结核均完全治愈。无结核复发感染。术后后凸角为6.6 - 10.2°,平均8.1°,末次随访时矫正度无明显丢失。所有病例均实现了坚固融合。所有患者术后神经功能均有改善。

结论

一期后路经椎间孔腰椎椎间融合术、病灶清除、有限减压、三柱重建及后路内固定可成为治疗单节段腰椎结核的一种可行且有效的方法。

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