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目的 分析后路长节段固定、前路病灶清除短节段融合在多节段胸腰椎结核手术中的应用价值.方法 回顾分析2008年1月至2015年12月间青岛市胸科医院收治的24例多节段胸腰椎结核患者的临床资料,均采用了后路长节段椎弓根钉棒内固定、前路病灶清除植骨短节段融合术治疗,重点观察手术时间、出血量、固定节段数、后凸畸形患者Cobb角恢复情况、影像学等.结果 24例患者平均手术时间(3.2±0.9)h;平均出血量(730±211)ml;固定节段4～10个椎体,平均7.5个椎体;9例融合2个间隙,15例融合1个间隙;12例后凸畸形者术后病变节段(后凸Cobb角10°～31°,平均25.8°)较术前(后凸Cobb角27°～50°,平均35.8°)均有所改善与纠正,差异有统计学意义(t=16.31,P＜0.01).术后患者脊髓损伤程度分级(Frankel)均达到E级.所有患者均获随访,时间12～60个月,平均(29.0±9.7)个月;术后6～12个月前路植骨均得到融合,无椎旁脓肿或腰大肌脓肿复发.结论 多节段胸腰椎结核采用后路长节段固定短节段融合治疗的创伤小,融合节段少,固定效果确切,内固定取出后可解放正常脊柱单位,恢复脊柱功能.“,”Objective To explore the application of long-segment fixation with pedicle screw and anterior lesion clearance and short-segmental fusion in the surgery of multiple thoracic and lumbar spinal tuberculosis.Methods Data of 24 multiple thoracic and lumbar spinal tuberculosis patients,treated with long-segment fixation with pedicle screw and anterior lesion clearance and short-segmental fusion,from Qingdao Chest Hospital between January 2008 to December 2015 were retrospectively analyzed.Duration of operation,blood loss,the number of fixed segments,Cobb angle recovery of kyphosis patients,imaging and so on were collected.Results The average uration of operation,blood loss were (3.2±0.9) hours and (730± 211) ml;4 10 vertebral segments with average of 7.5 vertebral bodies were fixed;2 segments were fused in 9 cases and 1 segment was fused in 15 cases;after treatment,the Cobb angle of 12 kyphosis cases was from 10° to 31° with average of 25.8 °,which was significantly different from that preoperative (range from 27°to 50° with average of 35.8°) (t=16.31,P＜0.01).Postoperative,Frankel grade of all cases reached grade E.All cases were followed up for 12 60 months with average of (29.0± 9.7) months.Bone graft fused in 6-12 months without relapse of paravertebral abscess or psoas abscess.Conclusion The trauma is small and the fusion segment is less in the treatment of posterior long-segment fixation with pedicle screw and anterior lesion clearance and short segmental fusion for multiple thoracic and lumbar spinal tuberculosis.To remove the internal fixation could liberate the normal spine unit and restore spinal function.