This study examined the clinical outcomes of one-stage surgical treatment for patients with spinal tuberculosis via a posterior-only approach. Twenty-four patients with thoracic or lumbar spinal tuberculosis whose les...This study examined the clinical outcomes of one-stage surgical treatment for patients with spinal tuberculosis via a posterior-only approach. Twenty-four patients with thoracic or lumbar spinal tuberculosis whose lesions were confined to adjacent segments were admitted to our hospital and treated. The American Spinal Injury Association(ASIA) impairment scale was used to assess the neurological function. All patients were treated with one-stage surgical treatment via a posterior-only approach. The clinical efficacy was evaluated by the Japanese Orthopaedic Association(JOA) scores and oswestry disability index(ODI) of nerve function. Patients were evaluated preoperatively and postoperatively by measurement of spinal deformity using Cobb angle and radiological examination. All the patients were followed up for 13 to 27 months. They had significantly postoperative improvement in JOA score, ODI and ASIA classification scores. The kyphotic angles were significantly corrected and maintained at the final follow-up. Bone fusion was achieved within 4–12 months. It was concluded that one-stage surgical treatment via a posterior-only approach is effective and feasible for the treatment of spinal tuberculosis.展开更多
目的对腰椎弓根与其毗邻神经结构的关系进行临床解剖学观察,以明确腰椎椎弓根与其毗邻神经的解剖关系和解剖数据。方法40例成人防腐尸体标本,男20例,女20例,进行解剖学观察,测量腰椎弓根上缘至且上位神经根下缘的最小距离(the distance ...目的对腰椎弓根与其毗邻神经结构的关系进行临床解剖学观察,以明确腰椎椎弓根与其毗邻神经的解剖关系和解剖数据。方法40例成人防腐尸体标本,男20例,女20例,进行解剖学观察,测量腰椎弓根上缘至且上位神经根下缘的最小距离(the distance from the pedicle to the adjacent nerve roots superiorly,DS)、腰椎弓根下缘至下位神经根上缘的最小距离(the distance from the pedicle to the adjacent nerve roots inferiorly,DI)、腰椎弓根外缘至外位神经根(上位神经根向外的延续部分)内缘的最小距离(the distance from the pedicle to the adjacent nerve roots lateral,DL)、腰椎弓根内缘至硬膜囊外缘或内侧神经结构的最小距离(the distance from the pedicle to the duralsac medially or neural structure inside,DM)。结果腰椎弓根与其毗邻神经关系的解剖数据,采用SPSS12.0统计软件进行统计学处理。左右腰椎弓根DS、DI、DL、DM无侧别差异;男性腰椎弓根DS、DI、DL、DM均大于女性;男性及女性DS>DL>DI>DM。结论腰椎椎弓根螺钉植入时,椎弓根的内侧区和下侧区毗邻神经结构相较外侧区和上侧区损伤可能性相对更大,植入螺钉时应遵循"宁外勿内,宁上勿下"的原则。展开更多
文摘This study examined the clinical outcomes of one-stage surgical treatment for patients with spinal tuberculosis via a posterior-only approach. Twenty-four patients with thoracic or lumbar spinal tuberculosis whose lesions were confined to adjacent segments were admitted to our hospital and treated. The American Spinal Injury Association(ASIA) impairment scale was used to assess the neurological function. All patients were treated with one-stage surgical treatment via a posterior-only approach. The clinical efficacy was evaluated by the Japanese Orthopaedic Association(JOA) scores and oswestry disability index(ODI) of nerve function. Patients were evaluated preoperatively and postoperatively by measurement of spinal deformity using Cobb angle and radiological examination. All the patients were followed up for 13 to 27 months. They had significantly postoperative improvement in JOA score, ODI and ASIA classification scores. The kyphotic angles were significantly corrected and maintained at the final follow-up. Bone fusion was achieved within 4–12 months. It was concluded that one-stage surgical treatment via a posterior-only approach is effective and feasible for the treatment of spinal tuberculosis.
文摘目的对腰椎弓根与其毗邻神经结构的关系进行临床解剖学观察,以明确腰椎椎弓根与其毗邻神经的解剖关系和解剖数据。方法40例成人防腐尸体标本,男20例,女20例,进行解剖学观察,测量腰椎弓根上缘至且上位神经根下缘的最小距离(the distance from the pedicle to the adjacent nerve roots superiorly,DS)、腰椎弓根下缘至下位神经根上缘的最小距离(the distance from the pedicle to the adjacent nerve roots inferiorly,DI)、腰椎弓根外缘至外位神经根(上位神经根向外的延续部分)内缘的最小距离(the distance from the pedicle to the adjacent nerve roots lateral,DL)、腰椎弓根内缘至硬膜囊外缘或内侧神经结构的最小距离(the distance from the pedicle to the duralsac medially or neural structure inside,DM)。结果腰椎弓根与其毗邻神经关系的解剖数据,采用SPSS12.0统计软件进行统计学处理。左右腰椎弓根DS、DI、DL、DM无侧别差异;男性腰椎弓根DS、DI、DL、DM均大于女性;男性及女性DS>DL>DI>DM。结论腰椎椎弓根螺钉植入时,椎弓根的内侧区和下侧区毗邻神经结构相较外侧区和上侧区损伤可能性相对更大,植入螺钉时应遵循"宁外勿内,宁上勿下"的原则。