Zeng Yanping, Wu Wenjie, Lyu Jingtong, Liu Xun, Tan Jiulin, Li Zhilin, Chen Yuan, Li Litao, Zheng Yonghong, Wang Gaoju, Xu Jianzhong, Zhang Zehua
Department of Orthopaedics, Southwest Hospital, Third Military Medical University, Chongqing, 400038, China.
Department of Orthopaedics, The Lanzhou General Hospital, Lanzhou Military Command of CPLA, Lanzhou, China.
BMC Musculoskelet Disord. 2019 Mar 4;20(1):95. doi: 10.1186/s12891-019-2466-7.
A multicentre retrospective study was conducted to evaluate the safety and efficacy of single-stage posterior debridement, decompression and transpedicular screw fixation for the treatment of thoracolumbar junction (T12-L1) tuberculosis in patients with associated neurological deficit.
Thoracolumbar junction (T12-L1) tuberculosis patients (n = 69) with neurological deficit who underwent single-stage posterior debridement, decompression and transpedicular screw fixation from January 2005 to January 2015 were included in the study. Antituberculosis therapy was performed both before and after surgery. The surgery duration and patient blood loss were evaluated, in addition to the change in pain visual analogue score (pVAS), kyphotic angle, Oswestry disability index (ODI) score and American Spinal Injury Association (ASIA) grade assessed preoperatively, immediate postoperatively and at the final follow-up visit.
The average blood loss was 354 ± 291 mL. The average kyphosis angle was corrected from 21 ± 9° preoperatively to 9 ± 4° postoperatively, with a mean decrease in pVAS and ODI scores of 3.4 and 16, respectively. The postoperative ASIA grading was grade A for five patients, grade C for 15 and grade D for 49 patients, which had improved to grade C for four patients, grade D for three patients and grade E for 62 patients at the final follow-up. The neurological deficit did not worsen in any of the patients.
Single-stage posterior debridement, decompression and transpedicular screw fixation is an effective treatment method in thoracolumbar junction (T12-L1) tuberculosis patients with neurological deficit, with good neurological recovery and no progression of kyphosis.
进行了一项多中心回顾性研究，以评估一期后路清创、减压及经椎弓根螺钉固定术治疗伴有神经功能缺损的胸腰段交界区（T12-L1）结核的安全性和有效性。
纳入2005年1月至2015年1月期间接受一期后路清创、减压及经椎弓根螺钉固定术治疗的伴有神经功能缺损的胸腰段交界区（T12-L1）结核患者（n = 69例）。术前及术后均进行抗结核治疗。评估手术时间和患者失血量，以及术前、术后即刻和末次随访时疼痛视觉模拟评分（pVAS）、后凸角、Oswestry功能障碍指数（ODI）评分和美国脊髓损伤协会（ASIA）分级的变化。
平均失血量为354±291 mL。平均后凸角从术前的21±9°矫正至术后的9±4°，pVAS和ODI评分平均分别下降3.4和16。术后ASIA分级为A级5例，C级15例，D级49例；末次随访时改善为C级4例，D级3例，E级62例。所有患者神经功能缺损均未加重。
一期后路清创、减压及经椎弓根螺钉固定术是治疗伴有神经功能缺损的胸腰段交界区（T12-L1）结核的有效方法，神经功能恢复良好，后凸畸形无进展。
