胸椎结核并完全截瘫的前路手术治疗及预后分析

摘要

目的：探讨重症胸椎结核并完全性瘫痪的前路手术方法及预后因素分析。方法：对胸椎结核并完全瘫痪的10例患者，行前路经胸途径结核病灶清除、植骨（或钛网）及1期内固定重建术，并行术后Frankel分级评估，对神经功能改善的相关因素进行分析。结果：10例病例均获得C级以上的恢复，2例术后5个月左右发生脊髓血管栓塞，导致下肢全瘫，经治疗后1例恢复，另1例无改善。结论：胸椎结核并完全截瘫的前路手术治疗效果较好。术前误放疗、血栓形成是预后不良的可能相关因素。%Objective:To discuss the technique and prognosis analysis of severe tuberculosis of thoracic vertebra with paraplegia. Methods:10 patients suffered with tuberculosis of thoracic vertebra with paraplegia underwent one-stage tuberculosis focus clearance and bone auto-graft (or titanium cage) fusion combined with internal fixation for treatment thoracic vertebrae tuberculosis via anterior ap-proach, the clinical outcome was reviewed retrospectively.All patients were evaluated neurological functions through Frankel grade.Re-sults:All patients with A grade recovered to C grade or D grade or E grade;5 months after operation, 2 patients contracted spinal embol-ism and paraplegia again.Through treatment, 1 patient was recovery, and the other one had no improvement.Conclusion:The treatment of thoracic vertebrae tuberculosis with paraplegia via anterior approach is effective.Preoperative radiotherapy by mistake and thrombopoie-sis are the possible correlation factor of unfavourable prognosis.