后路个体化病椎置钉联合前路小切口病灶清除治疗腰椎结核

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Abstract Objective: To determine the efficacy of posterior individual fixation combined with anterior mini-open debridement and strut graft for the treatment of lumbar spinal tuberculosis. Methods: From February 2011 to May 2014, a total of 62 cases with lumbar spinal tuberculosis were treated with posterior individual fixation combined with anterior debridement and strut graft. The cohort comprised 33 males and 29 females with an average age of 51.3 years. The pre-operative Frankel grading showed that 2 cases were grade B, 8 grade C, 16 grade D, and 36 grade E. Anti-tuberculosis therapy was carried out for two to four weeks, and the operation plan was determined by symptoms, signs and image. The clinical efficacy was evaluated based on the kyphosis Cobb angle, the visual analogue scale (VAS), erythrocyte sedimentation rate (ESR) and the Frankel grade system before and after the surgery. Results: The average follow-up duration was 23.7 months (15-36 months). There were three patients presented with psoas abscess after three months on the contralateral side, and cured by drainage. At the final follow-up the Frankel grading showed that 1 was grade C, 5 were grade D, and 56 were grade E. The Cobb’s angle was decreased from (16.34°±3.19°) (pre-operation) to (4.52°±1.69°). The visual analogue scale (VAS) was decreased from (6.72±1.02) (pre-operation) to (2.06±0.73). The erythrocyte sedimentation rate (ESR) was decreased from (40.12±1.53) mm/1 h (pre-operation)to (10.67±0.72) mm/1 h. Graft union was observed 3 to 7 months after surgery, with a mean of 4.6 months. There was no vertebral tuberculous relapse or screw loose/abruption. Conclusion: It is effective to treat lumbar tuberculous with posterior individual fixation combined with anterior mini-open debridement and strut graft.

Key words： tuberculosis spinal spinal fusion bone transplantation

Received: 08 October 2015

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	YING Xiaozhang
	ZHENG Qi
	SHI Shiyuan
	SHEN Jian
	WANG Yifan
	ZHU Bo
	HAN Guihe
	ZHENG Mingfeng.

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2016/V46/I4/274

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