Objective To compare the clinical efficacy of simple anterior approach and one-stage surgery via combined anterior-posterior approach in the treatment of spinal tuberculosis,in order to provide evidences for clinical doctors.Methods From May 2010 to May 2015,68 adult patients with spinal tuberculosis in our hospital were divided into two groups according to the surgical method.Group A included 30 patients who were implemented with the simple anterior approach;group B included 38 patients who received one-stage surgery via combined anterior-posterior approach.The changes of operative time,intraoperative blood loss,hospital stay,erythrocyte sedimentation rate (ESR),ASIA classification of spinal cord injury and Cobb angle were analyzed statistically.Results There were no statistically significant differences between two groups in operative time,blood loss,hospital stay,ESR and ASIA classification of spinal cord injury (P＞0.05).But the intra-group analysis showed that the preoperative ESR and ASIA classification of spinal cord injury had statistically significant differences compared with postoperation (P＜0.05).In terms of correction of Cobb angle,group B was significantly better than group A (P＜0.05).Conclusion Both simple anterior approach and one-stage surgery via combined anterior-posterior approach can effectively remove the lesion,correct deformity and achieve satisfactory results.But the group B is better than group A in kyphosis correction and to avoid loss of correction terms.%目的 比较一期前后路联合手术与单纯前路手术治疗脊柱结核临床疗效,为临床医师选择正确的手术方式提供依据.方法 回顾性分析我院于2005-05-2015-05间收治的68例脊柱结核患者.将68例脊柱结核患者按照手术方式分为两组,A组为实施单纯前路手术患者30例;B组为实施一期前后路联合手术患者38例.应用统计学方法对比分析两组手术时间、术中出血量、住院天数、血沉等指标及ASIA脊髓损伤分级、Cobb角等指标的变化情况.结果 两组患者均接受了随访,随访时间为12～48个月,平均(26.2±6.6)个月.两组组间比较在手术时间、术中出血量、住院天数、血沉及ASIA脊髓损伤分级等方面无明显统计学差异(P＞0.05),组内分析血沉及ASIA脊髓损伤分级术前与术后变化具有统计学差异(P＜0.05).在Cobb角矫正方面B组明显优于A组,具有统计学差异(P＜0.05).结论 单纯前路手术与一期前后路联合手术均能有效的清除病灶,矫正畸形,取得较为满意的结果.一期前后路联合手术在后凸畸形的矫正方面优于单纯前路手术.
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