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目的 :探讨经前路小切口清除椎体结核病灶联合后路矫形固定融合一期手术治疗合并后凸畸形的小儿胸椎结核的疗效。方法 :观察采用上述术式治疗的 32例合并后凸畸形的小儿胸椎结核患者的治疗效果 ,主要包括局部病灶有无复发、后凸畸形术后近期矫正度及后凸畸形远期变化等。结果 :术前平均后凸角为 50°(30°～ 70°) ,术后近期平均为 2 5°(2 0°～ 40°) ,随访 1～ 7年 (平均 3 2年 )后凸角平均为 2 5°(1 5°～ 45°)。 2 0例合并不同程度瘫痪者下肢肌力均提高 1～ 2级 ,3例尿潴留患儿于术后 3～ 6个月恢复排尿功能。 3例于术后 2～ 4年出现椎板下钢丝断裂。最后一次随访时所有患者均未见原脊柱结核病灶复发。结论 :经前路小切口清除椎体结核病灶联合后路矫形固定融合一期手术治疗合并后凸畸形的小儿胸椎结核效果满意
Objective: To investigate the effect of anterior small incision in removing tuberculosis of the vertebral tuberculosis combined with posterior approach orthopedic fixation and fusion surgery for pediatric thoracic tuberculosis with kyphosis. Methods: To observe the therapeutic effect of 32 cases of pediatric thoracic tuberculosis with kyphosis treated by the above-mentioned procedure, including the recurrence of local lesion, the short-term correction of kyphosis and the long-term change of kyphosis. Results: The average preoperative kyphosis angle was 50 ° (30 ° ~ 70 °) and the average postoperative short angle was 25 ° (20 ° ~ 40 °). Follow-up 1-7 years (average 32 years) The average is 25 ° (15 ° ~ 45 °). Twenty cases of paralysis with different degrees of paralysis increased 1 ~ 2 lower limb muscle strength, 3 cases of urinary retention in children after 3 to 6 months to restore urinary function. 3 cases in 2 to 4 years after the occurrence of lamina wire fracture. No recurrence of original spinal tuberculosis was seen in all patients at the last follow-up. Conclusion: The anterior small incision to clear the vertebral tuberculosis combined posterior fixed orthopedic fusion surgery for kyphotic pediatric thoracic tuberculosis with satisfactory results