[Effect of surgical timing on effectiveness of thoracic spinal tuberculosis with myelopathy].

To explore the feasibility of posterior debridement, decompression, bone grafting, and fixation in treatment of thoracic spinal tuberculosis with myelopathy, and investigate the effects of surgical timing on postoperative outcomes. The clinical data of 26 patients with thoracic spinal tuberculosis with myelopathy between August 2012 and October 2015 was retrospectively analyzed. All patients underwent posterior unilateral transpedicular debridement, decompression, bone grafting, and fixation and were divided into two groups according to surgical timing. Group A included 11 patients with neurological dysfunction lasting less than 3 months; group B included 15 patients with neurological dysfunction lasting more than 3 months. No significant difference was found between the two groups in gender, age, involved segments, preoperative erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Cobb angle of involved segment, and preoperative American Spinal Injury Association (ASIA) classification ( All patients were followed up 25-60 months (mean, 41.6 months). No cerebrospinal fluid leakage occurred intra- and post-operation. The hospitalization stay and perioperative complications in group A were significantly less than those of group B ( Posterior unilateral transpedicular debridement, decompression, bone grafting, and fixation is effective in treatment of thoracic spinal tuberculosis with myelopathy. Early surgery can reduce the hospitalization stays and incidence of perioperative complications. 探讨后路病灶清除脊髓减压植骨内固定治疗伴脊髓损害的胸椎结核的可行性，比较手术时机对术后疗效的影响。. 回顾分析 2012 年 8 月—2015 年 10 月收治的 26 例胸椎结核伴脊髓损害患者临床资料。所有患者行后方经单侧椎弓根入路病灶清除脊髓减压植骨内固定术，其中 11 例出现脊髓损害症状至手术时间<3 个月（A 组）、15 例出现脊髓损害症状至手术时间>3 个月（B 组）。两组患者性别、年龄、病变节段及术前红细胞沉降率、C 反应蛋白、病变节段 Cobb 角、美国脊髓损伤协会（ASIA）分级等一般资料比较，差异均无统计学意义（ 两组患者均获随访，随访时间 25～60 个月，平均 41.6 个月。术中、术后均无脑脊液漏发生。A 组住院时间及围术期并发症均显著少于 B 组（ 对伴有脊髓损害的胸椎结核患者，采用后方经单侧椎弓根入路病灶清除脊髓减压植骨内固定术治疗可以取得满意效果，尽早手术可以缩短患者住院时间、降低围术期并发症发生风险。.