简介：　　 [摘要 ]目的 探讨后入路小切口清创植骨联合经皮椎弓根钉内固定治疗胸腰椎结核的临床效果。方法 选取 2017年 6月～ 2019年 6月我院收治的胸腰椎结核患者作为研究对象，按照患者接受的不同手术方式，分为对照组（ 31例）与观察组（ 28例），对照组采用后路清创内固定术治疗，观察组采用后路小切口清创植骨联合经皮椎弓根钉内固定术治疗，两组术后随访时间均为 12个月。比较两组的手术时间、术中出血量、术后引流量、术后畸形矫正情况、神经功能恢复情况、伤口愈合率、病灶清除情况。结果 观察组的術中出血量、术后引流量均少于对照组，术后伤口Ⅰ期愈合率显著高于对照组，差异均有统计学意义（ P<0.05）。两组的手术时间、术后畸形矫正情况、神经功能恢复情况、病灶完全清除率比较，差异均无统计学意义（ P>0.05）。结论 后入路小切口清创植骨联合经皮椎弓根钉内固定术能减少手术创伤，减少出血量及引流量，减少内固定物与结核病灶创面直接接触，提高伤口愈合率及手术成功率，并能有效清除病灶，促进神经功能恢复及后凸畸形矫正，可为胸腰椎结核手术的治疗提供新尝试。  　　 [关键词 ]脊柱结核；单纯后路；经皮椎弓根钉；椎间植骨；病灶清除  [Abstract] Objective To investigate the clinical effect of small incision debridement and bone grafting combined with percutaneous pedicle screw fixation in the treatment of thoracolumbar tuberculosis. method Patients with thoracolumbar tuberculosis admitted to our hospital from June 2017 to June 2019 were selected and divided into control group (31 cases) and observation group (28 cases) according to different surgical methods. The control group was treated with posterior debridement and internal fixation, and the observation group was treated with posterior debridement and bone grafting combined with percutaneous pedicle screw internal fixation. The postoperative follow-up time of both groups was 12 Months. The operation time, intraoperative blood loss, postoperative drainage, postoperative deformity correction, neurological function recovery, wound healing rate and lesion clearance were compared between the two groups. Results the intraoperative blood loss and postoperative drainage volume of the observation group were less than those of the control group, and the wound healing rate of the observation group was significantly higher than that of the control group (P < 0.05). There was no significant difference in operation time, postoperative deformity correction, neurological function recovery and lesion complete clearance rate between the two groups (P > 0.05). Conclusion Posterior approach small incision debridement and bone grafting combined with percutaneous pedicle screw fixation can reduce surgical trauma, blood loss and drainage volume, reduce the direct contact between the internal fixation and the wound surface of tuberculosis, improve the wound healing rate and surgical success rate, effectively remove the focus, promote the recovery of nerve function and kyphosis correction, which can provide a new attempt for the treatment of thoracolumbar tuberculosis surgery.