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[目的]探讨后路病灶清除、植骨融合内固定术治疗胸腰椎结核的疗效,并比较钛笼与自体髂骨块植骨重建椎骨缺损的疗效差异.[方法]回顾性分析2011年1月～ 2013年12月行后路病灶清除、植骨融合内固定治疗的49例单节段胸腰椎结核患者的临床资料.其中钛笼组25例、髂骨块组24例.观察VAS评分、ODI评分、Cobb 角和椎间高度的改善及丢失、神经功能恢复情况、植骨融合时间及术后并发症等.[结果]平均随访35.3 (15～56)个月;术后植骨均融合.两组Cobb角和椎间高度的矫正较术前改善,组间差异无统计学意义(P＞0.05).钛笼组Cobb角和椎间高度丢失明显少于髂骨块组(P＜0.05).神经功能较术前明显改善.主要并发症有脑脊液漏(钛笼组1例)、窦道形成(钛笼组和髂骨块组各1例)、术区椎间隙感染(髂骨块组1例),无内置物及取髂骨区相关并发症.[结论]后路手术治疗胸腰椎结核可获得良好的临床疗效,结核病灶累及单节段时自体髂骨与钛笼植骨重建椎骨缺损均是较佳选择.“,”[Objective] To investigate the clinical outcome of posterior debridement,bone graft fusion,and pedicle screw fixation in the treatment of thoracic and lumbar spinal tuberculosis,and to compare the therapeutic effects of titanium mesh and autogenous iliac bone graft for vertebra defects.[Methods] A retrospective analysis was performed on the clinical data of 49 patients with single-segment thoracic and lumbar spinal tuberculosis who underwent posterior debridement,bone graft fusion,and internal fixation in our hospital from January 2011 to December 2013.Patients were divided into group A (n=25) and group B (n =24).In group A,the patients underwent posterior focus clearance,internal fixation,and reconstruction using formed titanium mesh.In group B,the patients underwent posterior reconstruction using autogenous iliac bone graft.The clinical outcome was evaluated based on Visual Analog Scale (VAS) score,Oswestry Disability Index (ODI) score,Cobb angle,intervertebral height,neurological status,bony fusion,postoperative complications,and so on.[Results] The patients were followed up for 35.3 months (15-56 months).The spinal tuberculosis was completely cured,and solid bony fusion was achieved for all patients.After surgery,both groups showed no significant improvements in Cobb angle and intervertebral height (P ＞0.05),and group A showed significantly less loss of Cobb angle and intervertebral height compared with group B (P ＜ 0.05).Both groups showed significant improvement in the neurological function after surgery (P ＞0.05).The following major complications were observed:cerebrospinal fluid leakage (1 case in group A),sinus formation (1 case in each of groups A and B),and intervertebral infection (1 case in group B).And no implant failure or donor site complication was present.[Conclusions] For thoracic and lumbar spinal tuberculosis,posterior surgery can achieve a good clinical outcome.When single-segment thoracic and lumbar spinal tuberculosis involved,titanium mesh or autogenous iliac bone graft is a good choice for reconstructing vertebra defects.