目的 探讨经胸膜外入路一期病灶清除钛笼植骨前路钢板内固定治疗胸椎结核的疗效.方法 对我院2008年6月至2010年9月,采用后外侧切口胸膜外入路一期病灶清除钛笼植骨前路钢板内固定治疗胸椎结核患者12例,对资料进行回顾性分析,随诊12-24个月,平均16个月.结果 术后神经功能改善10例,有效率83.3%;术后无一例局部结核复发或胸腔内结核扩散;术后随诊12-24个月的12例患者均显示植骨处骨性融合.结论 经胸廓胸膜外病灶清除椎管减压加植骨内固定治疗胸椎结核合并截瘫,能促进病灶愈合及截瘫恢复,矫正后凸畸形和有效维持脊柱的稳定性.%Objective To evaluate curative effect via extraplcural approach in one-stage radical debridement and titanium cage interbody autografting anterior plate internal fixation for the treatment of thoracic spinal tuberculosis. Methods 12 cases were analyzed retrospectively adopted thorax posterior lateral incision extrapleural approach in one-stage radical debridement and titanium cage interbody autografting anterior plate internal fixation for treating thoracic spinal tuberculosis. All had been followed up for 2 - 46 months, average 24 months. The data was from June 2008 to September 2010. Results Neurological function had improved in I0 cases after operation, and the effective rate was 83.3％. There was no case with local tuberculosis recurrence or intrathoracic med tuberculosis diffusion, and bone graft integration appeared in all the cases. Conclusion Extrapleural approach in one-stage radical debridcment and titanium cage interbody autografting anterior plate internal fixation can promote lesions healing and rehabilitation of paraplegics, rectified kyphotic deformity and maintain effective spinal stability.
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