摘要
目的:评估一期后路全脊椎截骨手术治疗静止型胸腰椎结核伴后凸畸形的疗效。方法:自1998年到2004年诊治静止型胸腰椎结核伴严重后凸畸形患者72例,均行一期后路全脊椎截骨矫形术,术前术后分别测量脊柱后凸Cobb角、侧位片上C7-S1水平距离及神经功能Frankel分级。结果:随访1～7年,平均27.8个月,后凸Cobb角术前平均为56.7°,术后平均为11.2°,平均矫正45.5°,矫正率80.2%;C7-S1水平距离术前平均为13.7mm,术后平均为3.8mm,矫正率72.3%;术前有神经功能障碍者19例,FrankelC级8例,D级11例,术后Frankel分级D级2例,神经功能改善率89.5%(17/19);术中并发症发生率为6.9%,术后并发症发生率为5.6%,永久性神经组织损害者1例,随访过程中未发现内固定相关并发症,所有病例均获得良好的骨性融合,矫正无显著丢失。结论:对静止型胸腰椎结核伴严重后凸畸形患者通过一期后路全脊椎截骨手术可获得良好的矫形结果,并发症发生率较低。
Objective：To evaluate clinic outcomes of en bloc spondylectomy in treatment of still spine tuberculosis with kyphotic deformity.Method：Form 1998 to 2004,72 still spine tuberculosis with kyphotic deformity cases operated with en bloc spondylectomy were analyzed retrospectively.In these cases,kyphotic Cobb angle, the horizontal distance between the C7 and S1 on the lateral view,and Frankel grade were measured before and after operation.Result：All cases were followed up 1～7 years with an average 27.8 monthes.Kyphotic Cobb angle was 56.7° and 11.2° respectively before and after operation,with averase correction 45.5°.Correcting rate was 80.2%.The horizontal distance between the C7 and S1 was 13.7mm and 3.Smm respectively before and after operation.Correcting rate was 72.3%.There were 19 cases with nerve symptom before operation,among which Frankle grade C was 8 cases and grade D l l cases.Nerve function improved 89.5% after operation （17/19,only 2 cases with grade D）.Complication rate was 6.9% and 5.6% during operation period and followup period respectively.Conclusion：En bloc spondylectomy in treatment of still spine tuberculosis with kyphotic deformity can achive an efficient and safe clinical outcome,and its complication rate was low.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2006年第3期204-207,共4页
Chinese Journal of Spine and Spinal Cord
