CAJ | 학술논문

目的：分析脊柱结核前后路不同术式的选择及疗效。方法选取2010年4月～2013年4月我院收治的成人腰骶段和胸腰椎结合患者188例，随机分成四组，每组47例。A组实施病灶前路清除手术、植骨融合术及前路内固定手术；B组实施椎弓根后路内固定手术、植骨融合术及病灶前路清除手术；C组实施病灶侧前方清除手术、植骨融合术及椎弓根后路内固定手术；D组实施病灶后路清除手术、椎弓根后路内固定手术及植骨融合术。对各组治疗效果进行观察。结果A组脊柱后凸畸形矫正率（47.5±11.8）%明显低于B、C、D组的（61.5±18.6）%、（58.7±15.9）%和（59.9±17.4）%（P＜0.05）；A组矫正角度丢失率（64.8±19.3）%明显高于B、C、D组的（53.6±15.6）%、（56.9±11.8）%和（54.9±5.4）%（P＜0.05）。结论治疗脊柱结核要依据正确的手术适应证选择不同的术式，从而将病灶清除、矫正脊柱后凸畸形；临床证明同前路固定手术方式相比，采用后路固定矫正脊柱后凸畸形能够取得更好的效果。
목적：분석척주결핵전후로불동술식적선택급료효。방법선취2010년4월～2013년4월아원수치적성인요저단화흉요추결합환자188례，수궤분성사조，매조47례。A조실시병조전로청제수술、식골융합술급전로내고정수술；B조실시추궁근후로내고정수술、식골융합술급병조전로청제수술；C조실시병조측전방청제수술、식골융합술급추궁근후로내고정수술；D조실시병조후로청제수술、추궁근후로내고정수술급식골융합술。대각조치료효과진행관찰。결과A조척주후철기형교정솔（47.5±11.8）%명현저우B、C、D조적（61.5±18.6）%、（58.7±15.9）%화（59.9±17.4）%（P＜0.05）；A조교정각도주실솔（64.8±19.3）%명현고우B、C、D조적（53.6±15.6）%、（56.9±11.8）%화（54.9±5.4）%（P＜0.05）。결론치료척주결핵요의거정학적수술괄응증선택불동적술식，종이장병조청제、교정척주후철기형；림상증명동전로고정수술방식상비，채용후로고정교정척주후철기형능구취득경호적효과。
Objective To analyze the selection and efficacy of different anterior and posterior surgical methods for spinal tuberculosis. Methods 188 adult patients with lumbosacral and thoracolumbar tuberculosis admitted to our hospital from April 2010 to April 2013 were randomly divided into 4 groups, with 47 patients in each group. Group A received lesion anterior clearance surgery, bone grafting fusion surgery and anterior internal fixation surgery;Group B received vertebral pedicle posterior internal fixation surgery, bone grafting fusion surgery and lesion anterior clearance surgery;Group C received lesion lateral anterior clearance surgery, bone grafting fusion surgery and vertebral pedicle posterior internal fixation surgery; Group D received lesion posterior clearance surgery, vertebral pedicle posterior internal fixation surgery and bone grafting fusion surgery. The treatment efficacy of each group was observed. Results Group A had a kyphosis correction rate of (47.5±11.8)%,which was significantly lower than the (61.5±18.6)%, (58.7±15.9)% and (59.9±17.4)% of group B, C and D (P < 0.05); Group A had a correction angel loss rate of (64.8±19.3)%, which was significantly higher than the (53.6±15.6)%,(56.9±11.8)%and (54.9±5.4)%of group B, C and D(P < 0.05). Conclusion Different surgical methods should be chosen based on the surgical indications of spinal tuberculosis in order to clear lesions and correct kyphosis; Compared to the anterior fixation surgical method, the application of posterior fixation in the correction of kyphosis can achieve better efficacy.