目的　观察病灶切除植骨、经椎弓根内固定术治疗脊柱结核的临床疗效。方法　 1 996年 1 0月至 1 998年 1 1月 ,我院有 34例胸腰椎结核患者接受椎弓根器械固定、一期或二期病灶切除植骨手术 ,术后随访 3～ 5年。结果　患者术后 1周左右腰背部疼痛和结核中毒症状缓解 ,术后约 4～ 6周时红细胞沉降率恢复正常 ,术后 4～ 6个月椎间植骨全部融合 ,脊柱结核全部治愈。有 1 2例患者术前脊柱后凸角度平均 2 4度 (1 0～ 32度 ) ,术后平均 9度 (5～ 1 3度 )。有 9例患者术前合并脊髓功能损害 (Frankel分级为C～D级 ) ,术后 1年内脊髓功能恢复正常。结论　病灶切除植骨经椎弓根内固定治疗脊柱结核 ,术后能立即恢复脊柱稳定性 ,免除了患者长期卧床之苦。此外 ,经椎弓根内固定还能够促进病灶愈合和缩短术后抗结核疗程 Objective To observe the clinical effect of resection and bone graft and pedicle screw fixation for spinal tuberculosis. Methods From January 1996 to January 1998, 34 patients with thoracolumbar vertebral tuberculosis in our hospital underwent pedicle instrumentation, one or two lesion resection and bone grafting. The patients were followed up for 3 to 5 years. Results The postoperative patients were relieved of back pain and tuberculosis poisoning about 1 week after operation. The erythrocyte sedimentation rate returned to normal after about 4 to 6 weeks after operation. All the intervertebral bone grafts were fused 4 to 6 months after operation, and the spinal tuberculosis was completely cured. Twelve patients had an average degree of kyphosis of 20 to 30 degrees and an average of 9 degrees (5 to 13 degrees) after surgery. Nine patients had spinal cord injury preoperatively (Frankel grade C to D), and spinal cord function returned to normal within 1 year after surgery. Conclusions The treatment of spinal tuberculosis by pedicle screw fixation and pedicle screw fixation can restore spinal stability immediately after operation, and relieve the patient from prolonged bed rest. In addition, the pedicle screw fixation can also promote the healing of the lesion and shorten the postoperative anti-TB treatment