目的 总结一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核疗效。 方法 2006年1月－2009年3月，对13例老年下腰椎结核患者行一期后路固定联合侧前方入路病灶清除植骨融合术治疗。男7例，女6例；年龄60～80岁，平均67.8岁。累及节段：L3、 4 1例，L4 1例， L4、 5 7例，L3～5 3例，L5、S1 1例。病程2～10个月，平均6.8个月。6例伴硬膜外脓肿，1例伴髂腰肌脓肿；7例不完全性瘫痪，根据脊髓损伤神经功能分级标准（ASIA）分级：C级2例，D级5例。 结果术中硬膜撕裂1例，术后切口均Ⅰ期愈合。13例均获随访，随访时间1～4年，平均37个月。植骨均获骨性融合，融合时间6～9个月。未发生内固定相关并发症，无局部结核复发。术后腰椎局部前凸角及Oswestry功能障碍指数（ODI）均较术前明显改善（P lt; 0.05）。神经功能ASIA分级除1例由C级恢复为D级外，余均恢复为E级。 结论一期后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核是一种安全、有效的方法。
Citation：
唐永超,梁德,江晓兵,杨志东,姚珍松,张顺聪,晋大祥. 一期经后路固定联合侧前方入路病灶清除植骨融合术治疗老年下腰椎结核. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(3): 382-383. doi: 10.7507/1002-1892.20130088
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- 1. Kim DJ, Yun YH, Moon SH, et al. Posterior instrumentation using compressive laminar hooks and anterior interbody arthrodesis for the treatment of tuberculosis of the lower lumbar spine. Spine (Phila Pa 1976), 2004, 29(13): E275-279.
- 2. 马君, 宋滇文, 邵将, 等. 一期前后路联合手术治疗下腰椎结核. 中国矫形外科杂志, 2010, 18(1): 13-16.
- 3. Rajasekaran S. The problem of deformity in spinal tuberculosis. Clin Orthop Relat Res, 2002, (398): 85-92.
- 4. Moon MS, Woo YK, Lee KS, et al. Posterior instrumentation and anterior interbody fusion for tuberculosis kyphosis of dorsal and lumbar spines. Spine (Phila Pa 1976), 1995, 20(17): 1910-1916.
- 5. Sai Kiran NA, Vaishya S, Kale SS, et al. Surgical results in patients with tuberculosis of the spine and severe lower-extermity motor dificits: a retrospective study of 48 patients. J Neuro surg Spine, 2007, 6(4): 320-326.
