【摘要】 [目的]探讨临床症状轻微型重度结核性脊髓压迫症的致病机理、临床特点及外科治疗方法。[方法]对15例临床症状轻微的重度结核性脊髓压迫症患者采用彻底病灶清除、植骨及选择性前路或后路器械内固定手术,分析手术适应证、疗效及外科治疗特点。[结果]术后随访6个月~7年,平均3.8年,15例患者结核病灶清除彻底,结核治愈无复发。合并不全瘫5例中,术前Frankel分级C级1例恢复至E级,D级4例中恢复至E级2例,1例无变化,1例术后脊髓功能损伤加重。[结论]临床症状轻微型结核性脊髓压迫因发病过程缓慢,脊髓有一定自行调整与适应时间和空间,但脊髓仍处于危象状态,早期手术可有效降低脊髓进行性损伤。
【关键词】 脊柱结核; 脊髓压迫; 病灶清除; 植骨; 内固定
Abstract:[Objective]To study the mechanism and clinic characteristic to the serious spinal cord compression from vertebral tuberculosis in the absence of nenrologic deficits.[Method]A total of 15 patients with serious spinal cord compression from vertebral tuberculosis in the absence of neurologic deficits were treated by onestage debridement,lilac grafting and internal fixation.The clinical characters were retrospectively analyzed.[Result]All these patients had no sinus formation and no recurrence of spinal tuberculosis during average the followup of 3.8 years(range:6 months to 7 years).In 5 cases with incomplete paraplegia,3 cases improved 2 grades,1 case was no change and 1 case be……
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