摘要
目的探讨经右侧胸腔一期植骨融合内固定治疗胸椎结核合并截瘫的疗效。方法对10例胸椎结核合并截瘫患者采用经右侧胸腔一期植骨融合内固定术(单钉棒固定6例,钉板固定4例)治疗,随访观察治疗效果。结果 10例患者均获随访,时间1～5年。神经功能恢复情况按ASIA分级:C级8例中6例术后4周内恢复至E级,2例术后3个月内恢复至E级;D级2例术后4周内均恢复至E级。患者血沉均恢复正常,未见结核复发,胸背痛消失。植骨全部融合,融合时间为3～8个月。结论采用经右胸腔前路一期植骨内固定治疗上胸椎结核合并截瘫是安全、有效的方法,且并发症少。
Objective To investigate the effects of surgical management for thoracic tuberculosis with neurological deficits using primary bone grafting and internal fixation through right anterior intrapleural approach.Methods All cases underwent primary anterior debridement,interbody autograft and anterior internal fixation via thoracic cavity.The clinical outcome was reviewed retrospectively.Results 10 cases were followed up for 1~5 years.Neurological deficits were evaluated by ASIA score system.The results showed that there were 6 cases in C grade were restored to E grade and 2 cases in D grade to E grade after 4 weeks of operation,and 2 case in C grade to E grade after 3 months of operation.All cases healed without any recurrence and complications such as infection,respiratory failure and so on.Spinal fusion was documented in 3~8 months after surgery.Conclusions It is a safe and effective method to use right anterior intropleural approach,primary autograft and internal fixation in the management of thoracic tuberculosis associated with neurological deficits.
出处
《临床骨科杂志》
2011年第6期615-616,共2页
Journal of Clinical Orthopaedics
关键词
胸椎
结核
脊柱
内固定术
截瘫
thoracic vertebrae
tuberculosis,spinal
internal fixation
paraplegia
