Single-stage transpedicular decompression and posterior instrumentation in treatment of thoracic and thoracolumbar spinal tuberculosis - A retrospective case series
Single-stage transpedicular decompression and posterior instrumentation in treatment of thoracic and thoracolumbar spinal tuberculosis - A retrospective case series
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治疗胸椎和胸腰椎结核的单段经椎间孔减压术和后路器械植入术--回顾性病例系列
DOI：
10.1097/01.bsd.0000211241.06588.7b
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发表时间：
2006-12-01
影响因子：
--
通讯作者：
Park, Yeun-Mook
中科院分区：
文献类型：
--
作者：
Lee, Sun-Ho;Sung, Joo-Kyung;Park, Yeun-Mook
目的：我们比较了一期后路手术与前路手术的手术效果，并提出一期后路手术、椎板切除、后路减压、经椎弓根内固定作为治疗胸椎和胸腰椎结核的一种替代手术方法。方法：从2001年1月至2004年12月，10例患者（组1），谁有较少的骨质破坏或医疗条件差，治疗后路减压和经椎弓根内固定，辅以后外侧骨融合和化疗。7例骨质破坏较大的患者（第2组）接受了前路减压、骨融合和前路内固定治疗。除1例死亡外，其余患者均获随访，平均18个月（6个月~ 3.5年）。结果：16例脊柱结核均获治愈，植骨均融合。所有病例的视觉模拟评分和Frankel分级均有所改善。没有可能与内固定相关的感染持续或复发。两组的放射学结果无差异。后凸畸形在手术治疗后得到明显矫正。结论：后路减压经椎弓根内固定是治疗脊柱结核的一种有效方法，尤其适用于早期骨质破坏或轻度后凸畸形的患者。
Objective: We compare the surgical results of single-stage posterior surgical procedure performed at a single institute with those of anterior procedure, and propose single-stage posterior surgical approach, laminectomy and posterior decompression with transpedicular instrumentation as an alternative operative method for thoracic and thoracolumbar spinal tuberculosis.Methods: From January 2001 to December 2004, 10 patients (group 1) who had less bone destruction or poor medical condition were treated with posterior decompression and transpedicular instrumentation that was supplemented with posterolateral bone fusion and chemotherapy. Seven patients (group 2) who had greater bone destruction were treated with anterior decompression, bone fusion, and anterior instrumentation. Except one case who expired, all patients were followed up for average 18 months (6 mo to 3.5 y):Results: Spinal tuberculosis was completely cured and the grafted bones were fused in all 16 patients. The visual analog scale and Frankel grade improved in all cases. There was no persistence or recurrence of infection possibly related to the instrumentation. There were no differences in the radiological results in both groups. The kyphosis was significantly corrected after surgical management. However, the loss of correction also occurred considerably in both groups.Conclusions: The posterior decompression with transpedicular instrumentation can be an alternative treatment method of less-involved spinal tuberculosis especially for patients in early phase of bone destruction or ones with mild kyphosis.