中国脊柱结核外科治疗指南(2022年版)

Chinese guidelines for surgical management of spinal tuberculosis (2022 edition)

摘要:

脊柱结核作为最常见的肺外继发性结核，一直是脊柱外科的常见病和多发病。规范的抗痨治疗是临床治愈脊柱结核的根本途径，但对于合并巨大椎旁脓肿、伴随神经压迫、出现脊柱失稳、后凸畸形等情况，往往还需要借助外科治疗来清除结核病灶、解除神经压迫、矫正畸形以及重建脊柱的稳定性。故此，外科治疗是脊柱结核治疗不可或缺的重要治疗手段；然而， 目前脊柱结核的外科治疗还存在许多问题。中华医学会结核病分会骨科专业委员会组织 60 余位全国脊柱结核领域专家，根据近年来国内外脊柱结核外科治疗的最新进展，借鉴国外相关指南，遵循循证医学原则，经过反复讨论，制定本指南。

Abstract:

Spinal tuberculosis, the most common extrapulmonary secondary tuberculosis, has been a common and frequently encoun- tered disease in spinal surgery. Standardized anti-tuberculosis treatment is the fundamental way to cure spinal tuberculosis in clinic. How- ever, for cases with huge paravertebral abscess, accompanied by nerve compression, spinal instability and kyphosis, surgical treatment is of- ten needed to remove tuberculosis foci, relieve nerve compression, correct deformity, and reconstruct spinal stability. Therefore, surgical treatment is an indispensable and important treatment for spinal tuberculosis. However, there are still many problems in the surgical treat- ment of spinal tuberculosis. According to the latest progress of surgical treatment of spinal tuberculosis at home and abroad in recent years, drawing on relevant foreign guidelines, following the principle of evidence-based medicine, 60 spinal tuberculosis experts were organized to develop this guideline by Orthopaedic Professional Committee of Chinese Society for Tuberculosis, Chinese Medical Associaition.