关键词: 多裂肌, 胸腰椎结核, 内固定, 融合

Abstract: 【Abstract】〓Objective〓To evaluate the clinical effect on surgical procedures of trans multifidus muscle gap and posterior midline approach in the treatment of thoracolumbar tuberculosis. Methods〓From March 2008 to March 2010,30 patients were diagnosed as spinal tuberculosis and treated with one-stage posterior surgery and anti-TB treatment, including 14 cases of the trans multifidus muscle gap approach (multifidus muscle gap group), 16 cases of conventional midline approach (traditional group). Short-segment pedicle screw fixation and posterior debridement,correction of kyphosis were used. The operative time, blood loss, postoperative drainage, hospital stay time, VAS score, ODI score, Cobb angle and interbody fusion were compared between two groups. Results〓Blood loss in trans multifidus muscle gap group and traditional group were in 230±70 mL and 550 ± 96 mL respectively(P<0.01). Postoperative drainage in two groups were in 185±56 mL and 479±118 mL respectively(P<0.01). Two groups of patients in the preoperative erythrocyte sedimentation rate were in 55-75 mm/h, and in the postoperative follow-up for 3~9 months,the ESR reached to normal level(<20 mm/h). Preoperative measurement of Cobb angle between multifidus musle gap group and the traditional group were 19.9±5.6° and 17.6±5.4° respectively, postoperative Cobb angle were 8.9±5.4° and 9.6±5.7°(P<0.01). Cobb angle correction showed no significant difference between two groups(P>0.05). In trans multifidus musle gap group,VAS scores and ODI score were better than that in traditional group in 6 weeks after operation,but no difference was observed in 24-36 months. And the incidence of complications in both groups, correction of kyphosis angle, fusion rate, recovery of neurological function showed no statistically significance. Conclusion〓Trans multifidus muscle gap approach has good clinical efficacy and gets rapid postoperative recovery.

Key words: Multifidus muscle, Thoracolumbar tuberculosis, Internal fixation, Fusion