Objective To study the clinical effects of posterior vertebral column resection orthomophia on old tuberculous spinal kyphosis, and to find out the preventive measures of complications via the treatment analysis over complications. Methods Retrospective analysis was conducted in 60 patients with old tuberculous spinal kyphosis who admitted in our hospital from November 2012 to November 2014, they were selected as the A study group. All patients were treated with posterior vertebral column resection orthomophia. The Cobb angular variation and the occurrence of complications before and 1 year after treatment, and the Frankel grading of neurological function before and after treatment were observed and compared. The appropriate complications prevention measures were made according to the occurrence of complications of patients. 35 patients with old tuberculous spinal kyphosis and treated by posterior vertebral column resection orthomophia from December 2015 to February 2017 in our hospital were selected as the B study group. The Cobb angular variation, correction rate and ODI scores were compared between the two groups. Results The mean Cobb angle was (85.34±7.32)° before treatment, and (28.67±3.23)° after treatment, the correction rate was 66.56%. After 1-year follow-up, the mean Cobb angle was (30.54±3. 54)°, and the correction rate was 60.70%. After treatment, patients with fine Frankel grading (level D and level E) were significantly more than before treatment, the difference was statistically significant (P<0.05). In the A study group, there were 18 cases(30.00%) with complications, and there were 3 cases of titanium rod fracture, 4 cases of nerve root injury, 5 cases of dural damage, 2 cases of internal fixation relaxation and 4 cases of neurological disorder. In the B study group, there were 4 cases (11.4%) of postoperative complications, and there was no titanium rod fracture and internal fixation, 1 case of nerve root injury, 1 case of dural damage and 2 cases of neurological dysfunction, which were significantly lower than those in the A study group, the difference was statistically significant (P<0.05). Conclusion Posterior vertebral column resection orthomophia has good efficacy, but relatively high incidence rate of complication in the treatment of patients with old tuberculous spinal kyphosis. Although intervention treatment can facilitate a fast recovery, positive preventive measures shall be taken in the perioperative period to reduce the incidence rate of complication.%目的 探究陈旧结核性脊柱后凸畸形患者采用后路全脊椎切除矫形手术治疗后的临床疗效,通过对并发症的治疗分析总结手术并发症的预防措施.方法 回顾性分析2012-11-2014-11期间我院收治的60例陈旧结核性脊柱后凸畸形病历资料为研究组A,所有患者均后路全脊椎切除矫形手术治疗,观察患者治疗前、术后1年Cobb角变化、并发症发生情况以及治疗前后神经功能Frankel分级.根据患者并发症发生情况制定相应并发症预防措施,选择2015-12-2017-02我院进行陈旧结核性脊柱后凸畸形并进行后路全脊椎切除矫形手术治疗患者35例为研究组B,比较两组术后Cobb角、矫正率以及ODI评分比较.结果 治疗前Cobb角平均(85.34±7.32)°,治疗后为(28.67±3.23)°,矫正率66.56%;随访1年Cobb角平均(30.54±3.54)°,矫正率60.70%;治疗后Frankel评级良好(D、E级)人数显著多于治疗前,差异具有统计学意义(P<0.05);研究组A术后发生并发症18例(30.00%),其中3例钛棒断裂、4例神经根损伤、5例硬膜损伤、2例内固定松动、4例神经功能障碍;研究组B术后并发症发生4例(11.4%),无钛棒断裂、内固定松动发生,1例神经根损伤、1例硬膜损伤、2例神经功能障碍,显著低于研究组A,差异具有统计学意义(P<0.05).结论 :陈旧结核性脊柱后凸畸形患者采用后路全脊椎切除矫形手术治疗后疗效良好,同时术后并发症发生率较高,经过干预治疗后能够快速恢复,但仍需要在围手术期采取积极的预防措施,减少并发症的发生率.
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