摘要
目的:探讨胸腰椎结核前路一期病灶清除、植骨内固定手术治疗的效果.方法:1996年4月～2000年8月采用前路一期病灶清除植骨内固定治疗胸腰椎结核患者56例,随访46例,观察术后和随访时神经功能恢复、畸形纠正、结核治愈率、植骨融合及并发症情况.结果:术后6个月时骨性融合率60%;12～18个月时90%融合;2年时100%融合.在胸段、胸腰段及腰段后凸畸形分别平均纠正19°、10°及9°,随访时无矫正度丢失;11例伴截瘫者神经功能平均恢复2级(Frankel分级);结核治愈率100%.并发症有继发结核性胸膜炎1例,相邻节段继发结核1例,均经抗结核化疗治愈.结论:脊柱前路一期病灶清除植骨内固定治疗胸腰椎结核具有能矫正后凸成角畸形、预防畸形复发、术后患者能早期离床活动等优点,治疗效果满意.
Objective:To review the efficacy of anterior debridement and fusion with internal fixation in thoracic or lumbar spine tuberculosis.Method:A total of46patients with thoracic and lumbar tuberculosis(T4~L5)were operated with a combination of anterior debridement,fusion and internal fixation with Rao' s Screw,VentroFix,Zplate,CD or USS instrumentations.Result:All the patients were followed up from3to7years(mean4years)post surgery.11cases with incomplete paraplegia improved2grades in average with Frankel neurological classifications.60%of all the46cases got solid fusion in6month,90%of them got fusion in12~18month,100%of them got fusion in2years.Kyphosis deformity was corrected from39°preoperatively to19°postoperatively.Conclusion:Patients with thoracic and/or lumbar spine tuberculosis can be successfully treated by combination of anterior debridement fusion and internal fixation.The procedure allows correction of deformation,early mobilization and avoiding recurrent of deformation.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2003年第11期652-655,共4页
Chinese Journal of Spine and Spinal Cord
关键词
植骨术
内固定
手术治疗
胸腰椎结核
疗效
并发症
神经功能
Spinal tuberculosis
Debridement
Fusion
Internal fixation[Author's address]Department of Orthopedics,Xi'an Red Cross Hospital,Xi'an,Shanxi,710054,China
