脊柱

吴相阳　朱乐全　陈麒麟　冉俊岭　杨卫宝　杨妍玮

Objective  To investigate the efficacy of posterior fixation and lesion debridement by posterolateral or anterolateral approach in the treatment of spinal tuberculosis. Methods  The clinical data of 38 patients with spinal tuberculosis who were treated by posterior fixation and lesion debridement at first stage from April 2007 to June 2011 were analyzed retrospectively. Among them, 19 patients with thoracic spinal tuberculosis were treated by lesion debridement by thoracic posterolateral approach at first stage after internal fixation by posterior nail bar system. 15 patients with lumbar spinal tuberculosis and 4 patients with lumbosacral spinal tuberculosis were treated by lesion debridement by lumbar anterolateral approach after internal fixation by posterior nail bar system and changed body position. After surgery, the anti-tuberculosis treatment was regulated continuously, and the patients were followed up in 3 aspects: the pain, deformity and improvement of nervous system. Results  All patients were followed up. 1 patient had mild chronic inflammation in the back incision and 2 patients did not get completely recovered in the function of the nervous system of both lower limbs. Poisoning symptoms of tuberculosis of all patients disappeared. The pain in the chest and back was improved obviously, and the kyphosis deformity was also improved. The cure rate of bone graft fusion was 92.1% (35/38). Conclusions  The efficacy of posterior fixation in the treatment of spinal tuberculosis and lesion debridement in the treatment of thoracic spinal tuberculosis and lumbar spinal tuberculosis by posterolateral or anterolateral approach is safe and satisfactory, and the regulation of anti-tuberculosis medication and nutritional support before and after surgery are the keys to ensure the efficacy.