摘要
目的探讨一期前后路联合手术治疗胸腰椎结核的临床疗效。方法对16例胸腰椎结核患者采用一期前路病灶清除植骨后路椎弓根钉-棒系统内固定术。结果患者术中均无神经障碍症状加重,切口均一期愈合,无窦道或瘘管形成。术后18个月停用抗结核药物。患者均获随访,时间18～24个月。结核均治愈,无复发;植骨融合均良好。患者神经功能障碍症状明显缓解,Frankel分级:C级3例恢复至E级2例、D级1例,D级5例均恢复至E级,E级8例仍为E级。结论胸腰椎结核患者采用前路病灶清除植骨、后路椎弓根钉-棒系统内固定术,既保证了病灶清除的彻底性、植骨融合内固定的可靠性,同时避免了切口感染造成的不愈合或窦道形成,是治疗胸腰椎结核安全可靠的理想术式。
Objective To explore the effect of anterior debridement and posterior internal fixation in one stage for thoracolumbar spinal tuberculosis.Methods 16 patients with thoracolumbar spinal tuberculosis were undergone anterior debridement and posterior pedicle screw-rod system fixation.Results Patients in this group had no neurological symptoms of deterioration.The wounds healed primarily without sinus or fistula formation.Anti-TB drugs was used for 18 months.All cases were followed up for 18 to 24 months.All patients TB cured.No relapse was found,and bone fusion was good.The neural function was improved.According to Frankel grading system,3 grade C were restored to E in 2 cases,and D in 1.All the 5 cases of grade D were restored to E.8 cases of grade E remained in E.Conclusions Thoracolumbar spinal tuberculosis can be treated with anterior debridement and posterior pedicle screw-rod system fixation,which ensures the thoroughness of debridement and internal fixation for fusion,while avoides the result of wound infection,nonunion or sinus formation.The treatment is safe and reliable for thoracolumbar spinal tuberculosis.
出处
《临床骨科杂志》
2011年第6期630-632,共3页
Journal of Clinical Orthopaedics
关键词
胸椎
腰椎
结核
脊柱
病灶清除
骨移植
内固定
thoracic vertebrae
lumbar vertebrae
tuberculosis,spinal
debridement
bone transplantation
internal fixation
