Lei Zhengting, Wang Ming, Xu Zhun, Cheng Wang, Yan Yiguo, Xue Jingbo
The First Affiliated Hospital, Department of Spine Surgery, Hengyang Medical School, University of South China, Hengyang, Hunan, 421001, China.
J Orthop Surg Res. 2025 May 13;20(1):460. doi: 10.1186/s13018-025-05861-6.
This was a retrospective study.
To retrospectively analyze the safety and efficacy of anterior lesion debridement and bone grafting combined with short-segment internal fixation for the treatment of patients with thoracolumbar tuberculosis. There is currently no unified standard in the academic community for surgical treatment of spinal tuberculosis. This study proposes a new surgical approach for specific thoracolumbar tuberculosis.
Patients (n = 65) who underwent anterior lesion debridement and bone grafting combined with short-segment internal fixation at our institution between January 2011 and January 2021 were included in this study. The patients were followed up for at least 2 years. During each follow-up, patients were graded using the American Spinal Injury Association (ASIA) neurologic deficit grading system, and postoperative conditions were evaluated using the Oswestry Disability Index (ODI) and pain visual analog scale (VAS).
All patients successfully completed the surgery without serious complications.Four patients had unstable vital signs during the operation, 3 patients had a water-electrolyte imbalance in the postoperative period, 5 patients had transient neurological symptoms in the postoperative period, 1 patient had cerebrospinal fluid leakage after the operation, 1 patient had a transient nerve injury, and 1 patient had delayed healing. The patient with recurrence was treated regularly with quadruple antituberculosis drugs for three months after surgery and then maintained with two oral antituberculosis drugs for the following period. The CT examination was repeated half a year later, and all the indexes showed that the prognosis was good. The patients' mean postoperative VAS and ODI scores were significantly better than the preoperative scores.
Anterior tuberculosis lesion debridement and bone grafting combined with short-segment internal fixation in the treatment of thoracolumbar tuberculosis has certain advantages over other Surgical Procedures, and can achieve corresponding clinical results.
这是一项回顾性研究。
回顾性分析前路病灶清除植骨联合短节段内固定治疗胸腰椎结核患者的安全性和有效性。目前学术界对于脊柱结核的手术治疗尚无统一标准。本研究针对特定的胸腰椎结核提出一种新的手术方法。
纳入2011年1月至2021年1月在我院接受前路病灶清除植骨联合短节段内固定手术的65例患者。对患者进行至少2年的随访。每次随访时，使用美国脊髓损伤协会（ASIA）神经功能缺损分级系统对患者进行分级，并使用Oswestry功能障碍指数（ODI）和疼痛视觉模拟量表（VAS）评估术后情况。
所有患者均成功完成手术，无严重并发症。4例患者术中生命体征不稳定，3例患者术后出现水电解质失衡，5例患者术后出现短暂神经症状，1例患者术后出现脑脊液漏，1例患者出现短暂神经损伤，1例患者愈合延迟。复发患者术后规律服用四联抗结核药物3个月，之后继续口服两种抗结核药物。半年后复查CT，各项指标显示预后良好。患者术后VAS和ODI评分均值均显著优于术前评分。
前路结核病灶清除植骨联合短节段内固定治疗胸腰椎结核相较于其他手术方法具有一定优势，且能取得相应的临床效果。
